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Global Health
June 16, 2020

New Hypertension Guidelines Apply to Diverse Socioeconomic Settings

JAMA. 2020;323(23):2363. doi:10.1001/jama.2020.9824

The International Society of Hypertension has released a simplified guideline for managing hypertension.

Globally, hypertension affects an estimated 1.39 billion people and is considered the leading cause of death worldwide, the authors wrote. Although many countries, particularly high-resource nations, release their own guidelines, those recommendations may be impractical in low- and middle-income settings where almost three-quarters of patients with hypertension reside. The new guideline was designed to be used in any setting by a range of clinicians including physicians, nurses, and community health workers.

“We believe these simplified guidelines will be of use globally and may be of most use in countries that do not have their own national hypertension practice guidelines,” coauthor Richard Wainford, PhD, of the Boston University School of Medicine, said in a statement.

The guideline defines hypertension as having a systolic blood pressure greater than or equal to 140 mm Hg and/or a diastolic blood pressure greater or equal to 90 mm Hg confirmed after several office visits. Home-based readings can also be used for diagnosis. Clinicians should suggest lifestyle modification as a first-line treatment for hypertension.

All patients with a blood pressure greater than or equal to 160/100 mm Hg and those with levels of 140 to 159/90 to 99 mm Hg who are at high risk of or have cardiovascular disease, chronic kidney disease, diabetes, or hypertension-mediated organ damage should receive medication immediately, according to the guideline. It also has recommendations for patients with comorbid conditions and treatment-resistant hypertension.