Clin Hypertens.  2019 ;25(1):20. 10.1186/s40885-019-0124-x.

2018 Korean Society of Hypertension Guidelines for the management of hypertension: part II-diagnosis and treatment of hypertension

Affiliations
  • 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 2Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Yonsei University, Seoul, Korea.
  • 4Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 5Department of Internal Medicine, Seoul National University, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 6Department of Internal Medicine, School of Medicine, Chonnam University, GwangJu, Korea.
  • 7Division of Cardiology, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea. scchae@knu.ac.kr
  • 8Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.
  • 9Cardiovascular Center, Seoul Hospital, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

Abstract

The standardized techniques of blood pressure (BP) measurement in the clinic are emphasized and it is recommended to replace the mercury sphygmomanometer by a non-mercury sphygmomanometer. Out-of-office BP measurement using home BP monitoring (HBPM) or ambulatory BP monitoring (ABPM) and even automated office BP (AOBP) are recommended to correctly measure the patient's genuine BP. Hypertension (HTN) treatment should be individualized based on cardiovascular (CV) risk and the level of BP. Based on the recent clinical study data proving benefits of intensive BP lowering in the high risk patients, the revised guideline recommends the more intensive BP lowering in high risk patients including the elderly population. Lifestyle modifications, mostly low salt diet and weight reduction, are strongly recommended in the population with elevated BP and prehypertension and all hypertensive patients. In patients with BP higher than 160/100"‰mmHg or more than 20/10"‰mmHg above the target BP, two drugs can be prescribed in combination to maximize the antihypertensive effect and to achieve rapid BP control. Especially, single pill combination drugs have multiple benefits, including maximizing reduction of BP, minimizing adverse effects, increasing adherence, and preventing cardiovascular disease (CVD) and target organ damage.

Keyword

Blood pressure; Measurement; Cardiovascular risk; Guidelines; Hypertension; Lifestyle; Antihypertensive treatment

MeSH Terms

Aged
Blood Pressure
Cardiovascular Diseases
Clinical Study
Diet
Humans
Hypertension*
Life Style
Prehypertension
Sphygmomanometers
Weight Loss
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