Core tip: Recently, the top medical journal BMJ published a clinical review from Professor Anthony J Viera and associate professor Emily m Hawes from the Department of Medicine of the University of North Carolina at Chapel Hill in the United States, aiming to introduce in detail the management of mild hypertension in adults.
Elevated blood pressure is a common risk factor for cardiovascular disease and affects one-third of adults worldwide. Taking antihypertensive drugs can greatly reduce the risk of stroke, coronary heart disease, heart failure, and premature death. However, most clinical trials show that antihypertensive drugs can produce beneficial effects in patients with moderate to severe hypertension, patients with definite cardiovascular disease, or patients with increased risk of cardiovascular disease. However, the efficacy of this therapy in patients with mild hypertension without cardiovascular disease is still unclear.
Recently, the top medical journal BMJ published a clinical review from Professor Anthony J Viera and associate professor Emily m Hawes from the Department of Medicine, University of North Carolina at Chapel Hill, USA, to introduce in detail the management of mild hypertension in adults.
The article points out that the recent meta-analysis provides some insights into the management of mild hypertension in adults. The pooled data from a large number of clinical trials in patients with mild hypertension show that stroke, death, and total mortality caused by cardiovascular disease in patients with mild hypertension are significantly reduced. The meta-analysis compared lower target blood pressure, and the results also showed that treatment for patients with mild hypertension was beneficial, although the net benefit of antihypertensive treatment for patients with a higher absolute risk of cardiovascular disease was greater.
Before starting medication, most patients with mild hypertension should have out of office blood pressure monitoring to diagnose hypertension. Lifestyle adjustment aimed at lowering blood pressure is suitable for all patients with hypertension, and lifestyle adjustment can be recommended for patients with a low absolute risk of cardiovascular disease and delayed drug treatment.
The individual blood pressure control of patients can be achieved by daily home blood pressure monitoring and low-cost antihypertensive drugs. For the population level, blood pressure control needs to rely on the improvement of intervention measures at the system level, such as mild hypertension registration, implementation of the evidence-based program, adjustment of drug follow-up, and performance indicators.
