Hypertension guidelines 2003 update

F. J. Milne; V. J. Pinkney-Atkinson; R. W. Charlton; H. Kakaza; K. P. Mokhobo; M. Mpe; D. P. Naidoo; G. Norton; L. Opie; Pinhas E. Sareli; Y. K. Seedat; H. C. Seftel; K. Steyn; D. R. Taylor; Y. Veriava; D. J.V. Weich; C. C. Kotzenberg; A. Croasdale; A. J. Dalby; S. Mazaza; L. Geffen; A. Bryer; G. Pappas; K. Steyn; P. Cole; A. Meyers; A. Motala; P. Mavengere; H. J. Odendaal; A. Combrinck; T. A. Gaziano; B. Taylor; A. van den Heever; R. Klein; N. Butkow; R. Potgieter; L. Anderson; T. Kruger; D. Webb; A. Becker; M. Frey; T. McCoy; M. Newton; M. Palane; M. Parkin; A. Maseko; S. Middlemost; P. S. Mntla; B. Rayner; B. van Rensburg; A. J. Woodiwiss; A. Mimran; K. Narkiewicz; E. O'Brien; N. Poulter; K. S. Reddy; B. Waeber; M. Connor; F. J. Raal; O. Oosthuizen; B. Onwubere; A. Damasceno

Hypertension guidelines 2003 update

F. J. Milne, V. J. Pinkney-Atkinson^*, R. W. Charlton, H. Kakaza, K. P. Mokhobo, M. Mpe, D. P. Naidoo, G. Norton, L. Opie, Pinhas E. Sareli, Y. K. Seedat, H. C. Seftel, K. Steyn, D. R. Taylor, Y. Veriava, D. J.V. Weich, C. C. Kotzenberg, A. Croasdale, A. J. Dalby, S. MazazaL. Geffen, A. Bryer, G. Pappas, K. Steyn, P. Cole, A. Meyers, A. Motala, P. Mavengere, H. J. Odendaal, A. Combrinck, T. A. Gaziano, B. Taylor, A. van den Heever, R. Klein, N. Butkow, R. Potgieter, L. Anderson, T. Kruger, D. Webb, A. Becker, M. Frey, T. McCoy, M. Newton, M. Palane, M. Parkin, A. Maseko, S. Middlemost, P. S. Mntla, B. Rayner, B. van Rensburg, A. J. Woodiwiss, A. Mimran, K. Narkiewicz, E. O'Brien, N. Poulter, K. S. Reddy, B. Waeber, M. Connor, F. J. Raal, O. Oosthuizen, B. Onwubere, A. Damasceno

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Cardiology

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Abstract

Outcomes. Extensive data from many randomised controlled trials have shown the benefit of treating hypertension. The target blood pressure (BP) for antihypertensive management should be systolic BP < 140 mmHg, diastolic < 90 mmHg, with minimal or no drug side-effects. However, a lesser reduction will elicit benefit although this is not optimal. The reduction of BP in the elderly and in those with severe hypertension should be achieved gradually over 6 months. Stricter BP control is required for patients with end organ damage, co-existing risk factors and co-morbidity, e.g. diabetes mellitus. Co-existent risk factors should also be controlled. Benefits. Reduction in risk of stroke, cardiac failure, renal insufficiency and probably coronary artery disease. The major precautions and contraindicationns to each antihypertensive drug recommended are listed. Recommendations. Correct BP measurement procedure is described. Evaluation of cardiovascular risk factors and recommendations for antihypertensive therapy are stipulated. The total cardiovascular diseasr risk profile should be determined for all patients and this should inform management strategies. Lifestyle modification and patient edcuation plays an essential role in the management strategy. Drug therapy. First line - low dose thiazide-like diuretics; second line - add one of the following: reserpine, or β-blockers or ACE inhibitors or calcium channel blockers; third line - add another second line drug or hydralazine or α-blocker. The guideline includes management of specific situations, i.e. hypertensive emergency and urgency, severe hypertension with target organ damage and refractory hypertension (BP>160/95 mmHg on triple therapy), hypertension in diabetes mellitus, etc. Validity. Developed by the Working Groups established by the Executive Committee of the Southern African Hypertension Society with broader consensus meeting endorsement. The 2001 version was endorsed by the South African Medical Association Guideline Committee. The 2003 revisions were endorsed by the Executive Committee and a wider Working Group.

Original language	English
Pages (from-to)	209-224
Number of pages	16
Journal	South African Medical Journal
Volume	94
Issue number	3
Publication status	Published - Mar 2004

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Milne, F. J., Pinkney-Atkinson, V. J., Charlton, R. W., Kakaza, H., Mokhobo, K. P., Mpe, M., Naidoo, D. P., Norton, G., Opie, L., Sareli, P. E., Seedat, Y. K., Seftel, H. C., Steyn, K., Taylor, D. R., Veriava, Y., Weich, D. J. V., Kotzenberg, C. C., Croasdale, A., Dalby, A. J., ... Damasceno, A. (2004). Hypertension guidelines 2003 update. South African Medical Journal, 94(3), 209-224.

@article{cc451593c2074ae6999c00470409671e,

title = "Hypertension guidelines 2003 update",

abstract = "Outcomes. Extensive data from many randomised controlled trials have shown the benefit of treating hypertension. The target blood pressure (BP) for antihypertensive management should be systolic BP < 140 mmHg, diastolic < 90 mmHg, with minimal or no drug side-effects. However, a lesser reduction will elicit benefit although this is not optimal. The reduction of BP in the elderly and in those with severe hypertension should be achieved gradually over 6 months. Stricter BP control is required for patients with end organ damage, co-existing risk factors and co-morbidity, e.g. diabetes mellitus. Co-existent risk factors should also be controlled. Benefits. Reduction in risk of stroke, cardiac failure, renal insufficiency and probably coronary artery disease. The major precautions and contraindicationns to each antihypertensive drug recommended are listed. Recommendations. Correct BP measurement procedure is described. Evaluation of cardiovascular risk factors and recommendations for antihypertensive therapy are stipulated. The total cardiovascular diseasr risk profile should be determined for all patients and this should inform management strategies. Lifestyle modification and patient edcuation plays an essential role in the management strategy. Drug therapy. First line - low dose thiazide-like diuretics; second line - add one of the following: reserpine, or β-blockers or ACE inhibitors or calcium channel blockers; third line - add another second line drug or hydralazine or α-blocker. The guideline includes management of specific situations, i.e. hypertensive emergency and urgency, severe hypertension with target organ damage and refractory hypertension (BP>160/95 mmHg on triple therapy), hypertension in diabetes mellitus, etc. Validity. Developed by the Working Groups established by the Executive Committee of the Southern African Hypertension Society with broader consensus meeting endorsement. The 2001 version was endorsed by the South African Medical Association Guideline Committee. The 2003 revisions were endorsed by the Executive Committee and a wider Working Group.",

author = "Milne, {F. J.} and Pinkney-Atkinson, {V. J.} and Charlton, {R. W.} and H. Kakaza and Mokhobo, {K. P.} and M. Mpe and Naidoo, {D. P.} and G. Norton and L. Opie and Sareli, {Pinhas E.} and Seedat, {Y. K.} and Seftel, {H. C.} and K. Steyn and Taylor, {D. R.} and Y. Veriava and Weich, {D. J.V.} and Kotzenberg, {C. C.} and A. Croasdale and Dalby, {A. J.} and S. Mazaza and L. Geffen and A. Bryer and G. Pappas and K. Steyn and P. Cole and A. Meyers and A. Motala and P. Mavengere and Odendaal, {H. J.} and A. Combrinck and Gaziano, {T. A.} and B. Taylor and {van den Heever}, A. and R. Klein and N. Butkow and R. Potgieter and L. Anderson and T. Kruger and D. Webb and A. Becker and M. Frey and T. McCoy and M. Newton and M. Palane and M. Parkin and A. Maseko and S. Middlemost and Mntla, {P. S.} and B. Rayner and {van Rensburg}, B. and Woodiwiss, {A. J.} and A. Mimran and K. Narkiewicz and E. O'Brien and N. Poulter and Reddy, {K. S.} and B. Waeber and M. Connor and Raal, {F. J.} and O. Oosthuizen and B. Onwubere and A. Damasceno",

year = "2004",

month = mar,

language = "English",

volume = "94",

pages = "209--224",

journal = "South African Medical Journal",

issn = "0256-9574",

publisher = "South African Medical Association",

number = "3",

}

Milne, FJ, Pinkney-Atkinson, VJ, Charlton, RW, Kakaza, H, Mokhobo, KP, Mpe, M, Naidoo, DP, Norton, G, Opie, L, Sareli, PE, Seedat, YK, Seftel, HC, Steyn, K, Taylor, DR, Veriava, Y, Weich, DJV, Kotzenberg, CC, Croasdale, A, Dalby, AJ, Mazaza, S, Geffen, L, Bryer, A, Pappas, G, Steyn, K, Cole, P, Meyers, A, Motala, A, Mavengere, P, Odendaal, HJ, Combrinck, A, Gaziano, TA, Taylor, B, van den Heever, A, Klein, R, Butkow, N, Potgieter, R, Anderson, L, Kruger, T, Webb, D, Becker, A, Frey, M, McCoy, T, Newton, M, Palane, M, Parkin, M, Maseko, A, Middlemost, S, Mntla, PS, Rayner, B, van Rensburg, B, Woodiwiss, AJ, Mimran, A, Narkiewicz, K, O'Brien, E, Poulter, N, Reddy, KS, Waeber, B, Connor, M, Raal, FJ, Oosthuizen, O, Onwubere, B & Damasceno, A 2004, 'Hypertension guidelines 2003 update', South African Medical Journal, vol. 94, no. 3, pp. 209-224.

TY - JOUR

T1 - Hypertension guidelines 2003 update

AU - Milne, F. J.

AU - Pinkney-Atkinson, V. J.

AU - Charlton, R. W.

AU - Kakaza, H.

AU - Mokhobo, K. P.

AU - Mpe, M.

AU - Naidoo, D. P.

AU - Norton, G.

AU - Opie, L.

AU - Sareli, Pinhas E.

AU - Seedat, Y. K.

AU - Seftel, H. C.

AU - Steyn, K.

AU - Taylor, D. R.

AU - Veriava, Y.

AU - Weich, D. J.V.

AU - Kotzenberg, C. C.

AU - Croasdale, A.

AU - Dalby, A. J.

AU - Mazaza, S.

AU - Geffen, L.

AU - Bryer, A.

AU - Pappas, G.

AU - Steyn, K.

AU - Cole, P.

AU - Meyers, A.

AU - Motala, A.

AU - Mavengere, P.

AU - Odendaal, H. J.

AU - Combrinck, A.

AU - Gaziano, T. A.

AU - Taylor, B.

AU - van den Heever, A.

AU - Klein, R.

AU - Butkow, N.

AU - Potgieter, R.

AU - Anderson, L.

AU - Kruger, T.

AU - Webb, D.

AU - Becker, A.

AU - Frey, M.

AU - McCoy, T.

AU - Newton, M.

AU - Palane, M.

AU - Parkin, M.

AU - Maseko, A.

AU - Middlemost, S.

AU - Mntla, P. S.

AU - Rayner, B.

AU - van Rensburg, B.

AU - Woodiwiss, A. J.

AU - Mimran, A.

AU - Narkiewicz, K.

AU - O'Brien, E.

AU - Poulter, N.

AU - Reddy, K. S.

AU - Waeber, B.

AU - Connor, M.

AU - Raal, F. J.

AU - Oosthuizen, O.

AU - Onwubere, B.

AU - Damasceno, A.

PY - 2004/3

Y1 - 2004/3

N2 - Outcomes. Extensive data from many randomised controlled trials have shown the benefit of treating hypertension. The target blood pressure (BP) for antihypertensive management should be systolic BP < 140 mmHg, diastolic < 90 mmHg, with minimal or no drug side-effects. However, a lesser reduction will elicit benefit although this is not optimal. The reduction of BP in the elderly and in those with severe hypertension should be achieved gradually over 6 months. Stricter BP control is required for patients with end organ damage, co-existing risk factors and co-morbidity, e.g. diabetes mellitus. Co-existent risk factors should also be controlled. Benefits. Reduction in risk of stroke, cardiac failure, renal insufficiency and probably coronary artery disease. The major precautions and contraindicationns to each antihypertensive drug recommended are listed. Recommendations. Correct BP measurement procedure is described. Evaluation of cardiovascular risk factors and recommendations for antihypertensive therapy are stipulated. The total cardiovascular diseasr risk profile should be determined for all patients and this should inform management strategies. Lifestyle modification and patient edcuation plays an essential role in the management strategy. Drug therapy. First line - low dose thiazide-like diuretics; second line - add one of the following: reserpine, or β-blockers or ACE inhibitors or calcium channel blockers; third line - add another second line drug or hydralazine or α-blocker. The guideline includes management of specific situations, i.e. hypertensive emergency and urgency, severe hypertension with target organ damage and refractory hypertension (BP>160/95 mmHg on triple therapy), hypertension in diabetes mellitus, etc. Validity. Developed by the Working Groups established by the Executive Committee of the Southern African Hypertension Society with broader consensus meeting endorsement. The 2001 version was endorsed by the South African Medical Association Guideline Committee. The 2003 revisions were endorsed by the Executive Committee and a wider Working Group.

AB - Outcomes. Extensive data from many randomised controlled trials have shown the benefit of treating hypertension. The target blood pressure (BP) for antihypertensive management should be systolic BP < 140 mmHg, diastolic < 90 mmHg, with minimal or no drug side-effects. However, a lesser reduction will elicit benefit although this is not optimal. The reduction of BP in the elderly and in those with severe hypertension should be achieved gradually over 6 months. Stricter BP control is required for patients with end organ damage, co-existing risk factors and co-morbidity, e.g. diabetes mellitus. Co-existent risk factors should also be controlled. Benefits. Reduction in risk of stroke, cardiac failure, renal insufficiency and probably coronary artery disease. The major precautions and contraindicationns to each antihypertensive drug recommended are listed. Recommendations. Correct BP measurement procedure is described. Evaluation of cardiovascular risk factors and recommendations for antihypertensive therapy are stipulated. The total cardiovascular diseasr risk profile should be determined for all patients and this should inform management strategies. Lifestyle modification and patient edcuation plays an essential role in the management strategy. Drug therapy. First line - low dose thiazide-like diuretics; second line - add one of the following: reserpine, or β-blockers or ACE inhibitors or calcium channel blockers; third line - add another second line drug or hydralazine or α-blocker. The guideline includes management of specific situations, i.e. hypertensive emergency and urgency, severe hypertension with target organ damage and refractory hypertension (BP>160/95 mmHg on triple therapy), hypertension in diabetes mellitus, etc. Validity. Developed by the Working Groups established by the Executive Committee of the Southern African Hypertension Society with broader consensus meeting endorsement. The 2001 version was endorsed by the South African Medical Association Guideline Committee. The 2003 revisions were endorsed by the Executive Committee and a wider Working Group.

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M3 - Article

C2 - 15114685

AN - SCOPUS:2342612721

SN - 0256-9574

VL - 94

SP - 209

EP - 224

JO - South African Medical Journal

JF - South African Medical Journal

IS - 3

ER -

Hypertension guidelines 2003 update

Abstract

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