Hypertension: treatment thresholds and continuing care
THE CONTEXT
Antihypertensive treatment decisions incorporate blood pressure readings and cardiovascular risk, with ongoing monitoring and support.
Intervention thresholds
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Both systolic and diastolic blood pressure are powerful predictors of cardiovascular risk; the management guidelines use both readings to determine when treatment should begin.
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Patients with diabetes or cardiovascular disease are particularly high risk. The source gives a lower threshold for initiating antihypertensive therapy in these groups, stated as ≤ 130/80 mmHg.
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Treatment initiation thresholds are the same in older and younger patients.
Assessment and follow-up
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Ambulatory blood pressure monitoring means ABPM; home blood pressure monitoring means HBPM. Home monitoring is offered if ambulatory monitoring is declined or not tolerated.
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Care includes assessment of cardiovascular risk and target organ damage, lifestyle interventions, and patient education to support adherence.
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Annual review includes blood pressure monitoring and discussion of lifestyle, symptoms and medication.