2004 Korean Hypertension Treatment Guideline and Its Perspective

Park, Jeong Bae

Abstract

The risk attributable to cardiovascular disease (CVD) that is induced by hypertension in the Korean population is 35% for stroke and 21% for ischemic heart disease. The prevalence of hypertension in persons older than 30 years is as high as 34.4% in men and 26.5% in women, and the prevalence of prehypertension is 39.4% in men and 30.6% in women. Therefore, the proportion of normotension is merely 28.4% in men and 47.3% in women. However, the current control rates (a systolic blood pressure (BP) <140 mmHg and a diastolic BP <90 mmHg), although improved, are still only (r)10%, which is far below those of western society. This situation urgently mandates a new guideline for making appropriate clinical decisions regarding the needs of individual patients and that this guideline can be applied with due regard to local circumstances and policies. Individuals with hypertension or prehypertension require health-promoting lifestyle modifications to prevent CVD. Drug treatment is recommended for most patients with uncomplicated hypertension that is persistently higher than 140/90 mmHg. The BP goal is less than 140/90 mmHg for most uncomplicated patients with hypertension, and less than 130/80 mmHg for the patients with diabetes or chronic kidney disease. In the absence of compelling indications, any kind of thiazidetype diuretics, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, beta-blockers or calcium channel blockers are recommended for initial use as antihypertensive drugs. If 2 or more drugs are needed to achieve the BP goal the committee recommends a treatment algorithm based on the AB/CD rule. Even though the committee had concerns on the guideline's accuracy due to the paucity of data on Korean people, the Korean Hypertension Treatment Guideline should be implemented to educate and guide both patients and physicians.