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Published in: Drugs 17/2014

Open Access 01-11-2014 | Review Article

Updated National and International Hypertension Guidelines: A Review of Current Recommendations

Authors: Sverre Kjeldsen, Ross D. Feldman, Liu Lisheng, Jean-Jacques Mourad, Chern-En Chiang, Weizhong Zhang, Zhaosu Wu, Wei Li, Bryan Williams

Published in: Drugs | Issue 17/2014

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Abstract

Despite the availability of effective pharmacological treatments to aid the control of blood pressure, the global rate of uncontrolled blood pressure remains high. As such, further measures are required to improve blood pressure control. Recently, several national and international guidelines for the management of hypertension have been published. These aim to provide easily accessible information for healthcare professionals and patients to aid the diagnosis and treatment of hypertension. In this review, we have compared new and current guidelines from the American and International Societies of Hypertension; the American Heart Association, American College of Cardiology and the US Center for Disease Control and Prevention; the panel appointed to the Eighth Joint National Committee; the European Societies of Hypertension and Cardiology; the French Society of Hypertension; the Canadian Hypertension Education Program; the National Institute for Health and Clinical Excellence (UK); the Taiwan Society of Cardiology and the Chinese Hypertension League. We have identified consensus opinion regarding best practises for the management of hypertension and have highlighted any discrepancies between the recommendations. In general there is good agreement between the guidelines, however, in some areas, such as target blood pressure ranges for the elderly, further trials are required to provide sufficient high-quality evidence to form the basis of recommendations.
Literature
2.
go back to reference He FJ, MacGregor GA. Cost of poor blood pressure control in the UK: 62000 unnecessary deaths per year. J Hum Hypertens. 2003;17:455–7.PubMedCrossRef He FJ, MacGregor GA. Cost of poor blood pressure control in the UK: 62000 unnecessary deaths per year. J Hum Hypertens. 2003;17:455–7.PubMedCrossRef
3.
go back to reference James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the eighth joint national committee (JNC 8). JAMA. 2014;311:507–20.PubMedCrossRef James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the eighth joint national committee (JNC 8). JAMA. 2014;311:507–20.PubMedCrossRef
4.
go back to reference Go AS, Bauman M, King SMC, et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. 2014;63:878–85.PubMedCrossRef Go AS, Bauman M, King SMC, et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension. 2014;63:878–85.PubMedCrossRef
5.
go back to reference Weber MA, Schiffrin EL, White WB, et al. Clinical practice guidelines for the management of hypertension in the community a statement by the American Society of Hypertension and the International Society of Hypertension. J Hypertens. 2014;32:3–15.PubMedCrossRef Weber MA, Schiffrin EL, White WB, et al. Clinical practice guidelines for the management of hypertension in the community a statement by the American Society of Hypertension and the International Society of Hypertension. J Hypertens. 2014;32:3–15.PubMedCrossRef
6.
go back to reference Dasgupta K, Quinn RR, Zarnke KB, et al. The 2014 Canadian Hypertension Education Program (CHEP) recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention and treatment of hypertension. Can J Cardiol. 2014;30:485–501.PubMedCrossRef Dasgupta K, Quinn RR, Zarnke KB, et al. The 2014 Canadian Hypertension Education Program (CHEP) recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention and treatment of hypertension. Can J Cardiol. 2014;30:485–501.PubMedCrossRef
7.
go back to reference Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34:2159–219.PubMedCrossRef Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34:2159–219.PubMedCrossRef
9.
go back to reference Blacher J, Halimi JM, Hanon O, et al. Management of hypertension in adults: the 2013 French Society of Hypertension guidelines. Fundam Clin Pharmacol. 2014;28:1–9.PubMedCrossRef Blacher J, Halimi JM, Hanon O, et al. Management of hypertension in adults: the 2013 French Society of Hypertension guidelines. Fundam Clin Pharmacol. 2014;28:1–9.PubMedCrossRef
10.
go back to reference Chiang C-E, Wang T-D, Li Y-H, et al. 2010 Guidelines of the Taiwan Society of Cardiology for the management of hypertension. J Formos Med Assoc. 2010;109:740–73.PubMedCrossRef Chiang C-E, Wang T-D, Li Y-H, et al. 2010 Guidelines of the Taiwan Society of Cardiology for the management of hypertension. J Formos Med Assoc. 2010;109:740–73.PubMedCrossRef
11.
go back to reference Liu LS. 2010 Chinese guidelines for the management of hypertension. Zhonghua Xin Xue Guan Bing Za Zhi. 2011;39:579–615.PubMed Liu LS. 2010 Chinese guidelines for the management of hypertension. Zhonghua Xin Xue Guan Bing Za Zhi. 2011;39:579–615.PubMed
12.
go back to reference Lovibond K, Jowett S, Barton P, et al. Cost-effectiveness of options for the diagnosis of high blood pressure in primary care: a modelling study. Lancet. 2011;378:1219–30.PubMedCrossRef Lovibond K, Jowett S, Barton P, et al. Cost-effectiveness of options for the diagnosis of high blood pressure in primary care: a modelling study. Lancet. 2011;378:1219–30.PubMedCrossRef
13.
go back to reference Beckett NS, Peters R, Fletcher AE, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358:1887–98.PubMedCrossRef Beckett NS, Peters R, Fletcher AE, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358:1887–98.PubMedCrossRef
14.
go back to reference Wright JT Jr, Fine LJ, Lackland DT, et al. Evidence supporting a systolic blood pressure goal of less than 150 mmHg in patients aged 60 years or older: the minority view. Ann Intern Med. 2014;160:499–503.PubMedCrossRef Wright JT Jr, Fine LJ, Lackland DT, et al. Evidence supporting a systolic blood pressure goal of less than 150 mmHg in patients aged 60 years or older: the minority view. Ann Intern Med. 2014;160:499–503.PubMedCrossRef
15.
go back to reference Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2007;28:1462–536.PubMed Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2007;28:1462–536.PubMed
16.
go back to reference Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42:1206–52.PubMedCrossRef Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42:1206–52.PubMedCrossRef
17.
go back to reference ACCORD Study Group. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010;362:1575–85.CrossRef ACCORD Study Group. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010;362:1575–85.CrossRef
18.
go back to reference Hansson L, Zanchetti A, Carruthers SG, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the hypertension optimal treatment (HOT) randomised trial. Lancet. 1998;351:1755–62.PubMedCrossRef Hansson L, Zanchetti A, Carruthers SG, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the hypertension optimal treatment (HOT) randomised trial. Lancet. 1998;351:1755–62.PubMedCrossRef
19.
go back to reference UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703–13.PubMedCentralCrossRef UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703–13.PubMedCentralCrossRef
20.
go back to reference Bangalore S, Kumar S, Lobach I, et al. Blood pressure targets in subjects with type 2 diabetes mellitus/impaired fasting glucose: observations from traditional and Bayesian random-effects meta-analyses of randomized trials. Circulation. 2011;123:2799–810.PubMedCrossRef Bangalore S, Kumar S, Lobach I, et al. Blood pressure targets in subjects with type 2 diabetes mellitus/impaired fasting glucose: observations from traditional and Bayesian random-effects meta-analyses of randomized trials. Circulation. 2011;123:2799–810.PubMedCrossRef
21.
go back to reference Cooper-DeHoff RM, Gong Y, Handberg EM, et al. TIght blood pressure control and cardiovascular outcomes among hypertensive patients with diabetes and coronary artery disease. JAMA. 2010;304:61–8.PubMedCentralPubMedCrossRef Cooper-DeHoff RM, Gong Y, Handberg EM, et al. TIght blood pressure control and cardiovascular outcomes among hypertensive patients with diabetes and coronary artery disease. JAMA. 2010;304:61–8.PubMedCentralPubMedCrossRef
22.
go back to reference Reboldi G, Gentile G, Angeli F, et al. Effects of intensive blood pressure reduction on myocardial infarction and stroke in diabetes: a meta-analysis in 73,913 patients. J Hypertens. 2011;29:1253–69.PubMedCrossRef Reboldi G, Gentile G, Angeli F, et al. Effects of intensive blood pressure reduction on myocardial infarction and stroke in diabetes: a meta-analysis in 73,913 patients. J Hypertens. 2011;29:1253–69.PubMedCrossRef
23.
go back to reference Arguedas JA, Perez MI, Wright JM. Treatment blood pressure targets for hypertension. Cochrane Database Syst Rev. 2009:CD004349. Arguedas JA, Perez MI, Wright JM. Treatment blood pressure targets for hypertension. Cochrane Database Syst Rev. 2009:CD004349.
24.
go back to reference Upadhyay A, Earley A, Haynes SM, et al. Systematic review: blood pressure target in chronic kidney disease and proteinuria as an effect modifier. Ann Intern Med. 2011;154:541–8.PubMedCrossRef Upadhyay A, Earley A, Haynes SM, et al. Systematic review: blood pressure target in chronic kidney disease and proteinuria as an effect modifier. Ann Intern Med. 2011;154:541–8.PubMedCrossRef
25.
26.
go back to reference Eckel RH, Jakicic JM, Ard JD, et al. AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation. 2014;129:25(Suppl. 2):S76–99. Eckel RH, Jakicic JM, Ard JD, et al. AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation. 2014;129:25(Suppl. 2):S76–99.
27.
go back to reference Simplicity HTN-1 Investigators. Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months. Hypertension. 2011;57:911–7.CrossRef Simplicity HTN-1 Investigators. Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months. Hypertension. 2011;57:911–7.CrossRef
29.
go back to reference Graudal N, Jürgens G, Baslund B, et al. Compared with usual sodium intake, low- and excessive-sodium diets are associated with increased mortality: a meta-analysis. Am J Hypertens. 2014;27:1129–37.PubMedCrossRef Graudal N, Jürgens G, Baslund B, et al. Compared with usual sodium intake, low- and excessive-sodium diets are associated with increased mortality: a meta-analysis. Am J Hypertens. 2014;27:1129–37.PubMedCrossRef
30.
go back to reference MRC Working Party. Medical Research Council trial of treatment of hypertension in older adults: principal results. BMJ. 1992;304:405–12.CrossRef MRC Working Party. Medical Research Council trial of treatment of hypertension in older adults: principal results. BMJ. 1992;304:405–12.CrossRef
31.
go back to reference Wiysonge CS, Bradley HA, Volmink J, et al. Beta-blockers for hypertension. Cochrane Database Syst Rev. 2012:CD002003. Wiysonge CS, Bradley HA, Volmink J, et al. Beta-blockers for hypertension. Cochrane Database Syst Rev. 2012:CD002003.
32.
go back to reference Bakris GL, Fonseca V, Katholi RE, et al. Metabolic effects of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension: a randomized controlled trial. JAMA. 2004;292:2227–36.PubMedCrossRef Bakris GL, Fonseca V, Katholi RE, et al. Metabolic effects of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension: a randomized controlled trial. JAMA. 2004;292:2227–36.PubMedCrossRef
33.
go back to reference Manrique C, Giles TD, Ferdinand KC, et al. Realities of newer β-blockers for the management of hypertension. J Clin Hypertens. 2009;11:369–75.CrossRef Manrique C, Giles TD, Ferdinand KC, et al. Realities of newer β-blockers for the management of hypertension. J Clin Hypertens. 2009;11:369–75.CrossRef
34.
go back to reference Bonet S, Agustí A, Arnau JM, et al. Β-adrenergic blocking agents in heart failure: benefits of vasodilating and nonvasodilating agents according to patients’ characteristics: a meta-analysis of clinical trials. Arch Intern Med. 2000;160:621–7.PubMedCrossRef Bonet S, Agustí A, Arnau JM, et al. Β-adrenergic blocking agents in heart failure: benefits of vasodilating and nonvasodilating agents according to patients’ characteristics: a meta-analysis of clinical trials. Arch Intern Med. 2000;160:621–7.PubMedCrossRef
35.
go back to reference Feldman RD, Zou GY, Vandervoort MK, et al. A simplified approach to the treatment of uncomplicated hypertension: a cluster randomized, controlled trial. Hypertension. 2009;53:646–53.PubMedCrossRef Feldman RD, Zou GY, Vandervoort MK, et al. A simplified approach to the treatment of uncomplicated hypertension: a cluster randomized, controlled trial. Hypertension. 2009;53:646–53.PubMedCrossRef
36.
go back to reference Jaffe MG, Lee GA, Young JD, et al. Improved blood pressure control associated with a large-scale hypertension program. JAMA. 2013;310:699–705.PubMedCrossRef Jaffe MG, Lee GA, Young JD, et al. Improved blood pressure control associated with a large-scale hypertension program. JAMA. 2013;310:699–705.PubMedCrossRef
37.
go back to reference Wald DS, Law M, Morris JK, et al. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 11,000 participants from 42 trials. Am J Med. 2009;122:290–300.PubMedCrossRef Wald DS, Law M, Morris JK, et al. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 11,000 participants from 42 trials. Am J Med. 2009;122:290–300.PubMedCrossRef
38.
go back to reference Corrao G, Parodi A, Zambon A, et al. Reduced discontinuation of antihypertensive treatment by two-drug combination as first step. Evidence from daily life practice. J Hypertens. 2010;28:1587–90.CrossRef Corrao G, Parodi A, Zambon A, et al. Reduced discontinuation of antihypertensive treatment by two-drug combination as first step. Evidence from daily life practice. J Hypertens. 2010;28:1587–90.CrossRef
39.
go back to reference ONTARGET Investigators. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med. 2008;358:1547–59.CrossRef ONTARGET Investigators. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med. 2008;358:1547–59.CrossRef
40.
go back to reference Parving H-H, Brenner BM, McMurray JJV, et al. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. N Engl J Med. 2012;367:2204–13.PubMedCrossRef Parving H-H, Brenner BM, McMurray JJV, et al. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. N Engl J Med. 2012;367:2204–13.PubMedCrossRef
41.
go back to reference Gupta AK, Arshad S, Poulter NR. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis. Hypertension. 2010;55:399–407.PubMedCrossRef Gupta AK, Arshad S, Poulter NR. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis. Hypertension. 2010;55:399–407.PubMedCrossRef
42.
go back to reference Kjeldsen SE, Messerli FH, Chiang C-E, et al. Are fixed-dose combination antihypertensives suitable as first-line therapy? Curr Med Res Opin. 2012;28:1685–97.PubMedCrossRef Kjeldsen SE, Messerli FH, Chiang C-E, et al. Are fixed-dose combination antihypertensives suitable as first-line therapy? Curr Med Res Opin. 2012;28:1685–97.PubMedCrossRef
43.
go back to reference Dickson M, Plauschinat CA. Racial differences in medication compliance and healthcare utilization among hypertensive medicaid recipients: fixed-dose vs free-combination treatment. Ethn Dis. 2008;18:204–9.PubMed Dickson M, Plauschinat CA. Racial differences in medication compliance and healthcare utilization among hypertensive medicaid recipients: fixed-dose vs free-combination treatment. Ethn Dis. 2008;18:204–9.PubMed
44.
go back to reference Dickson M, Plauschinat CA. Compliance with antihypertensive therapy in the elderly: a comparison of fixed-dose combination amlodipine/benazepril versus component-based free-combination therapy. Am J Cardiovasc Drugs. 2008;8:45–50.PubMedCrossRef Dickson M, Plauschinat CA. Compliance with antihypertensive therapy in the elderly: a comparison of fixed-dose combination amlodipine/benazepril versus component-based free-combination therapy. Am J Cardiovasc Drugs. 2008;8:45–50.PubMedCrossRef
45.
go back to reference The ALLHAT Officers. Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). JAMA. 2002;288:2981–97.CrossRef The ALLHAT Officers. Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). JAMA. 2002;288:2981–97.CrossRef
46.
go back to reference Leenen FHH, Nwachuku CE, Black HR, et al. Clinical events in high-risk hypertensive patients randomly assigned to calcium channel blocker versus angiotensin-converting enzyme inhibitor in the antihypertensive and lipid-lowering treatment to prevent heart attack trial. Hypertension. 2006;48:374–84.PubMedCrossRef Leenen FHH, Nwachuku CE, Black HR, et al. Clinical events in high-risk hypertensive patients randomly assigned to calcium channel blocker versus angiotensin-converting enzyme inhibitor in the antihypertensive and lipid-lowering treatment to prevent heart attack trial. Hypertension. 2006;48:374–84.PubMedCrossRef
48.
go back to reference Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ. 2009;19:b1665.CrossRef Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ. 2009;19:b1665.CrossRef
49.
go back to reference Esler MD, Krum H, Schlaich M, et al. Renal sympathetic denervation for treatment of drug-resistant hypertension: one-year results from the symplicity htn-2 randomized, controlled trial. Circulation. 2012;126:2976–82.PubMedCrossRef Esler MD, Krum H, Schlaich M, et al. Renal sympathetic denervation for treatment of drug-resistant hypertension: one-year results from the symplicity htn-2 randomized, controlled trial. Circulation. 2012;126:2976–82.PubMedCrossRef
50.
go back to reference Symplicity HTN-2 Investigators, Esler MD, Krum H, et al. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet. 2010;376:1903–9.PubMedCrossRef Symplicity HTN-2 Investigators, Esler MD, Krum H, et al. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet. 2010;376:1903–9.PubMedCrossRef
51.
go back to reference Shimamoto K, Ando K, Fukita T, et al. The Japanese society of hypertension guidelines for the management of hypertension (JSH 2014). Hypertens Res. 2014;37(4):253–387.PubMedCrossRef Shimamoto K, Ando K, Fukita T, et al. The Japanese society of hypertension guidelines for the management of hypertension (JSH 2014). Hypertens Res. 2014;37(4):253–387.PubMedCrossRef
53.
go back to reference McAlister FA, Feldman RD, Wyard K, et al. The impact of the Canadian hypertension education programme in its first decade. Eur Heart J. 2009;30:1434–9.PubMedCrossRef McAlister FA, Feldman RD, Wyard K, et al. The impact of the Canadian hypertension education programme in its first decade. Eur Heart J. 2009;30:1434–9.PubMedCrossRef
54.
go back to reference Peterson ED, Gaziano J, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes? JAMA. 2013;311:474–6.CrossRef Peterson ED, Gaziano J, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes? JAMA. 2013;311:474–6.CrossRef
Metadata
Title
Updated National and International Hypertension Guidelines: A Review of Current Recommendations
Authors
Sverre Kjeldsen
Ross D. Feldman
Liu Lisheng
Jean-Jacques Mourad
Chern-En Chiang
Weizhong Zhang
Zhaosu Wu
Wei Li
Bryan Williams
Publication date
01-11-2014
Publisher
Springer International Publishing
Published in
Drugs / Issue 17/2014
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.1007/s40265-014-0306-5

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