Medical researchers released new guidelines aimed at physicians treating patients suffering from hypertension.
The report was released in hopes of reducing the patients' "disease burden" and to help them better-manage their condition, a University of Alabama at Birmingham news release reported.
"Hypertension is the most common condition seen in primary care and leads to heart attack, stroke, kidney failure and death if not detected early and treated appropriately," Suzanne Oparil, M.D., University of Alabama at Birmingham professor of Medicine and director of the vascular biology and hypertensive program in UAB's School of Medicine, said. "This report takes a rigorous, evidence-based approach to recommend treatment thresholds, goals and medications in the management of hypertension in adults. In utilizing randomized clinical trials, we used the highest level of medical evidence that one can have, and this is a process that is endorsed by The Institute of Medicine of the National Academy of Sciences."
The reported includes nine recommendations for better hypertension health that addresses three questions.
The questions ask: "In adults with hypertension, does initiating antihypertensive pharmacologic therapy at specific blood pressure thresholds improve health outcomes?; In adults with hypertension, does treatment with antihypertensive pharmacologic therapy to a specified blood pressure goal lead to improvements in health outcomes?;" and "In adults with hypertension, do various antihypertensive drugs or drug classes differ in comparative benefits and harms on specific health outcomes?"
The new guideline is believed to be an improvement to the previous version because its recommendations address the questions above and tries to tailor their "goals" to the majority of the hypertension population excluding subgroups that have different needs. The report also includedes a threshold blood pressure level that indicates the need to begin treatment.
The report loosens the recommendations on how many people need to be on prescription medication for hypertension.
"There is very clear evidence that treating high blood pressure in people 60 and older to a goal of <150/<90 reduces stroke, heart attacks and heart disease," Oparil said. "There is no evidence that lowering blood pressure further offers additional health benefits, and, further, taking unnecessary medication may increase the burdens on patients, resulting in additional time in the doctor's office and expensive testing."
The report also strongly recommends physicians regularly check patients' blood pressure, and take their lifestyles into account.
"The potential benefits of a healthy diet, weight control and regular exercise for all persons with hypertension cannot be overemphasized," Oparil said. "These lifestyle treatments have the potential to improve blood pressure and even reduce medication needs."
The report named the most effective medicines as "diuretics, calcium channel blockers (CCBs), angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs)."
"All of those have shown to be useful in the general patient with high blood pressure," Oparil said. "For nonblack patients, all of those classes seem to be equal. For blacks, CCBs and thiazide-type diuretics seem to be better than the ARBs or ACEIs in first-line treatment. Once that's been accomplished, add drugs from other classes with complementary mechanisms of action."
