MANAGEMENT GUIDELINES FOR HYPERTENSION - IS ANYONE TAKING NOTICE

A number of national bodies and the World Health Organisation/Internat ional Society of Hypertension have published guidelines on the treatme nt of hypertension, and there is reasonable consensus between them, Re peated and accurate BP measurements are an essential starting point in the clinical management of hypertension, In mild-to-moderate hyperten sion, nonpharmacological treatments should always be instituted and th eir impact evaluated before drugs are considered. The recommended dias tolic threshold for initiation of drug therapy varies between 90 and 1 00 mmHg and the systolic threshold lies between 140 and 160 mmHg. Ther e is also agreement that this threshold should be reduced to 140/90 mm Hg when multiple risk factors co-exist, The generally accepted aim of treatment is to reduce DBP to < 90 mmHg, but there is controversy abou t lowering it further to < 80 mmHg. There is convincing evidence that elderly patients benefit most from treatment, It is also clear that tr eated patients with inadequately controlled BP remain at high risk of premature cardiovascular death. This highlights the need for guideline s that are suitable for routine use in clinical practice.