Making Best Practice, Every Day Practice
Since the publication of the National Institute for Health and Clinical Excellence (NICE) clinical guidance (CG 127) on the management of hypertension in adults two years ago, new evidence has been published which is relevant to – and potentially has an impact on – the guideline recommendations. This evidence is presented and reviewed in the following article.
There still remains a significant gap between the goal of optimal treatment of hypertension and ‘real life’ practice. As a consequence, hypertension remains a leading cause of cardiovascular related morbidity and mortality. There is a continuing need to improve both the detection and management of hypertension, with a view to improving the efficacy of treatment including lifestyle interventions and outcomes. In order to address these issues. The European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) have recently published guidance on the management of arterial hypertension.
We evaluated the accuracy and predictive value of conventional BP measurements performed by primary care physicians in comparison with ABPM in a cross-sectional study of hypertensive patients in primary healthcare. We found that conventional BP measurements are less accurate than 24-hour ABPM.
Despite the availability of effective therapies, there remains poor awareness, diagnosis and management of hypertension across the globe. Effective treatment requires an understanding of the underlying disease processes involved in hypertension which includes chronic increased sympathetic activity and peripheral resistance rather than focusing simply on blood pressure reduction. The differing pathophysiological response patterns of younger […]
Important modifications to the NICE clinical guideline on management of hypertension include changes in definitions of the stages of hypertension, greater use of ambulatory and home blood pressure monitoring, changes in treatment recommendations for those aged over 80 and changes in antihypertensive drug treatment recommendations.
Issues and challenges in hypertension management today
Dr Chris Arden GP, Chandlers Ford; GPSI Cardiology, Southampton
Most hypertensive patients fail to achieve their target blood pressure despite treatment. As a result, they have a significantly increased risk of stroke and heart attack. Primary care professionals can correct this situation, reducing morbidity and mortality through accurate blood pressure measurement and effective treatment, often with more than one drug. The availability of a new angiotensin receptor blocker, Azilsartan medoxomil, provides an important addition to the choice of available treatment.
This video offers primary care professionals a focussed review of high blood pressure, its measurement and modern treatment.
This sponsored video has been organised and funded by Takeda UK
Prescribing Information for Edarbi®-(azilsartan medoxomil) can be seen hereCode: AZL121001d. Date of prep: December 2012
High blood pressure is undoubtedly the major modifiable risk factor for cardiovascular disease (CVD). However, despite advances in management, it remains inadequately managed. Across Europe, only about one in four of treated patients achieve guideline-recommended targets for blood pressure. This has important consequences for increasing the risk of CVD, kidney disease, microvascular disease, as well […]
The recent guideline from the National Institute for Health and Clinical Excellence (NICE) on the clinical management of primary hypertension enables us to provide evidence-based care to patients with high blood pressure (BP). The guideline provides a clear treatment algorithm, starting with A (an ACE inhibitor or angiotensin 2 receptor blocker) or C (a calcium channel blocker), depending on the age of the patient, then combining them if target BP is not reached and then adding in D (a diuretic) if required. This article uses a series of case studies to illustrate diagnosis and treatment based on the new guidelines.
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