title: Guideline for the diagnosis and management of hypertension in adults - 2016.
abstract: The National Heart Foundation of Australia has updated the Guide to management of hypertension 2008: assessing and managing raised blood pressure in adults (updated December 2010). Main recommendations For patients at low absolute cardiovascular disease risk with persistent blood pressure (BP) ≥ 160/100 mmHg, start antihypertensive therapy. The decision to treat at lower BP levels should consider absolute cardiovascular disease risk and/or evidence of end-organ damage, together with accurate BP assessment. For patients at moderate absolute cardiovascular disease risk with persistent systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, start antihypertensive therapy. Treat patients with uncomplicated hypertension to a target BP of < 140/90 mmHg or lower if tolerated. Changes in management as a result of the guideline Ambulatory and/or home BP monitoring should be offered if clinic BP is ≥ 140/90 mmHg, as out-of-clinic BP is a stronger predictor of outcome. In selected high cardiovascular risk populations, aiming for a target of < 120 mmHg systolic can improve cardiovascular outcomes. If targeting < 120 mmHg, close follow-up is recommended to identify treatment-related adverse effects including hypotension, syncope, electrolyte abnormalities and acute kidney injury. Why the changes have been made A 2015 meta-analysis of patients with uncomplicated mild hypertension (systolic BP range, 140-169 mmHg) demonstrated that BP-lowering therapy is beneficial (reduced stroke, cardiovascular death and all-cause mortality). A 2015 trial comparing lower with higher blood pressure targets in selected high cardiovascular risk populations found improved cardiovascular outcomes and reduced mortality, with an increase in some treatment-related adverse events.
authors.affiliation: Royal Adelaide Hospital, Adelaide, SA genevieve.gabb@sa.gov.au.
authors.forename: Genevieve M
authors.initials: GM
authors.lastname: Gabb
authors.affiliation: Flinders Medical Centre, Flinders University, Adelaide, SA.
authors.forename: Arduino A
authors.initials: AA
authors.lastname: Mangoni
authors.affiliation: The George Institute for Global Health, Sydney, NSW.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Anderson
authors.affiliation: Princess Alexandra Hospital, Brisbane, QLD.
authors.forename: Diane
authors.initials: D
authors.lastname: Cowley
authors.affiliation: Australian Prescriber, Canberra, ACT.
authors.forename: John S
authors.initials: JS
authors.lastname: Dowden
authors.affiliation: Queensland Research Centre for Peripheral Vascular Disease, James Cook University, Townsville, QLD.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Golledge
authors.affiliation: University of Western Australia, Perth, WA.
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Hankey
authors.affiliation: Royal Adelaide Hospital, Adelaide, SA.
authors.forename: Faline S
authors.initials: FS
authors.lastname: Howes
authors.affiliation: Royal Adelaide Hospital, Adelaide, SA.
authors.forename: Les
authors.initials: L
authors.lastname: Leckie
authors.affiliation: The George Institute for Global Health, Sydney, NSW.
authors.forename: Vlado
authors.initials: V
authors.lastname: Perkovic
authors.affiliation: Royal Adelaide Hospital, Adelaide, SA.
authors.forename: Markus
authors.initials: M
authors.lastname: Schlaich
authors.affiliation: Royal Adelaide Hospital, Adelaide, SA.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Zwar
authors.affiliation: Royal Adelaide Hospital, Adelaide, SA.
authors.forename: Tanya L
authors.initials: TL
authors.lastname: Medley
authors.affiliation: Royal Adelaide Hospital, Adelaide, SA.
authors.forename: Leonard
authors.initials: L
authors.lastname: Arnolda
mesh_terms: D000328:Adult; D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001315:Australia; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000295:instrumentation; D018660:Blood Pressure Monitoring, Ambulatory / Q000295:instrumentation; D002318:Cardiovascular Diseases / Q000517:prevention & control; D005260:Female; D006801:Humans; D006973:Hypertension / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D020521:Stroke / Q000517:prevention & control
chemical_list: D000959:Antihypertensive Agents