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Guidelines on the choice of agents and how best to step up treatment for various subgroups in hypertension (high blood pressure) have changed over time and differ between countries. A Comparison of International Guidelines on Goal Blood Pressure and Initial Therapy for Adults With Hypertension (adapted from JNC 8 guidelines [ 1 ] )
Guidelines for treating resistant hypertension have been published in the UK [45] and US. [46] It has been proposed that a proportion of resistant hypertension may be the result of chronic high activity of the autonomic nervous system, known as "neurogenic hypertension". [47] Low adherence to treatment is an important cause of resistant ...
In 2017, with the American guidelines' change in definition for hypertension, 46% of people in the United States are affected. [6] Some data shows African-American adults in the United States have among the highest rates of hypertension in the world at 44%. [163]
In 2003, the AHA and the American Stroke Association created the Get With the Guidelines (GWTG)-Stroke program. [79] It is a voluntary registry that hospitals can use to receive the latest scientific treatment guidelines. [80] The program also collects data on patient characteristics, hospital adherence to guidelines, and patient outcomes. [79]
[49] [56] According to the 2017 [57] American Heart Association blood pressure guidelines state that a systolic blood pressure of 130–139 mmHg with a diastolic pressure of 80–89 mmHg is "stage one hypertension".
For mild blood pressure elevation, consensus guidelines call for medically supervised lifestyle changes and observation before recommending initiation of drug therapy. However, according to the American Hypertension Association, evidence of sustained damage to the body may be present even prior to observed elevation of blood pressure.
Careful monitoring for signs of end-organ damage or progression to hypertension is an important part of the follow-up of patients with prehypertension. Any change in blood pressure classification should be confirmed on at least one subsequent visit. The major indication for pharmacologic antihypertensive therapy is progression to hypertension.
The Systolic Blood Pressure Intervention Trial (SPRINT) is a multi-center clinical trial that was performed from 2010 to 2015, and published in November 2015. [1]The objective of the trial was to identify whether, in patients with a systolic blood pressure (SBP) of 130 mm Hg or higher and an increased cardiovascular risk, but without diabetes, treating to a systolic blood pressure target of ...