South African hypertension practice guideline 2014
نویسندگان
چکیده
OUTCOMES Extensive data from many randomised, controlled trials have shown the benefit of treating hypertension (HTN). The target blood pressure (BP) for antihypertensive management is systolic < 140 mmHg and diastolic < 90 mmHg, with minimal or no drug side effects. Lower targets are no longer recommended. The reduction of BP in the elderly should be achieved gradually over one month. Co-existent cardiovascular (CV) risk factors should also be controlled. BENEFITS Reduction in risk of stroke, cardiac failure, chronic kidney disease and coronary artery disease. RECOMMENDATIONS Correct BP measurement procedure is described. Evaluation of cardiovascular risk factors and recommendations for antihypertensive therapy are stipulated. Lifestyle modification and patient education are cornerstones of management. The major indications, precautions and contra-indications are listed for each antihypertensive drug recommended. Drug therapy for the patient with uncomplicated HTN is either mono- or combination therapy with a low-dose diuretic, calcium channel blocker (CCB) and an ACE inhibitor (ACEI) or angiotensin receptor blocker (ARB). Combination therapy should be considered ab initio if the BP is ≥ 160/100 mmHg. In black patients, either a diuretic and/or a CCB is recommended initially because the response rate is better compared to an ACEI. In resistant hypertension, add an alpha-blocker, spironolactone, vasodilator or β-blocker. VALIDITY The guideline was developed by the Southern African Hypertension Society 2014©.
منابع مشابه
South African Hypertension Guideline 2011
This is the 5th hypertension guideline published by the Southern African Hypertension Society (SAHS). It is an important step towards implementing a national standard to improve the quality of care for persons living with hypertension. The realistic objectives described can be applied widely and aim to diminish the impact of hypertension and related cardiovascular disease (CVD) risk in South Af...
متن کاملVenous thromboembolism: prophylactic and therapeutic practice guideline.
BACKGROUND Pharmacological prophylactic anticoagulation in many countries, including South Africa, is under-prescribed. This has resulted in unacceptable rates of morbidity and mortality. METHOD The Southern African Society of Thrombosis and Haemostasis held a meeting to update the previous guideline and review new literature including guidelines from other societies. The following specialtie...
متن کاملAngiotensin converting enzyme inhibitors v. angiotensin receptor blockers in the management of hypertension: a funder's perspective.
BACKGROUND Hypertension poses a huge financial risk to any funder/medical aid, including the risk-mitigating strategies provided by the managed care organisations that are required to manage patients with hypertension. The South African Hypertension Guideline states that the choice of therapy--an angiotensin converting enzyme inhibitor (ACEI) or an angiotensin receptor blocker (ARB)--should be ...
متن کاملSouth African Guidelines Excellence (SAGE): Adopt, adapt, or contextualise?
Clinical practice guideline (CPG) activities must be planned carefully for efficient use of available resources and evidence-based implementation. De novo development of CPGs may sometimes 'recreate the wheel' and delay implementation. Three innovative alternatives to de novo CPG development (adopt, contextualise or adapt) are outlined, which have greater potential than de novo development to b...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 25 شماره
صفحات -
تاریخ انتشار 2014