AHA, ACC, CDC issue science advisory on hypertension
The American Heart Association (AHA), American College of Cardiology (ACC), and Centers for Disease Control and Prevention (CDC) issued a recent science advisory on control of hypertension.
The American Heart Association (AHA), American College of Cardiology (ACC), and Centers for Disease Control and Prevention (CDC) issued a recent science advisory on control of hypertension.
The advisory stated that system-level approaches will be needed to reduce hypertension prevalence in the U.S., involving the following factors:
- identifying all patients eligible for management,
- monitoring at the practice/population level,
- increasing patient and clinician awareness,
- providing an effective diagnosis and treatment guideline,
- systematically following up patients for initiation and intensification of therapy,
- clarifying roles of clinicians to implement a team approach,
- reducing barriers for patients to receive and adhere to medications and implement lifestyle modifications and
- leveraging electronic medical record systems to support these steps.
As part of a multipronged approach, the AHA, ACC and CDC developed a treatment algorithm intended to apply to the largest number of hypertensive patients while being flexible and detailed enough to support individualized therapy. The algorithm divides patients into those with stage 1 hypertension (systolic blood pressure 140 to 159 mm Hg or diastolic blood pressure 90 to 99 mm Hg) and stage 2 hypertension (systolic blood pressure >160 mm Hg or diastolic blood pressure >100 mm Hg). In the first group, a trial of lifestyle modification and consideration of thiazide therapy are recommended. In the second group, 2 drugs are preferred in addition to lifestyle modifications: thiazide and an angiotensin-converting enzyme (ACE) inhibitor, angiotensin-receptor blocker, or calcium-channel blocker, or consideration of an ACE inhibitor and calcium-channel blocker.
The algorithm also offers a step-by-step method for rechecking and reviewing blood pressure, as well as ways to encourage patients who successfully control their blood pressure and actions to take when blood pressure is not at goal. The science advisory and algorithm were published by Hypertension on Nov. 15 and are available free of charge online.