Guideline for the pharmacological treatment of

hypertension in adults: summary

More people die each year from cardiovascular disease (CVD) than from any other cause.
In 2019, out of 56 million deaths,
18 million were due to CVD.

Diseases of the heart, brain, kidneys and other organs

are significantly increased by hypertension (HTN),
which afflicts about 1.28 billion people worldwide,
Only 23% of women and 18% of men have it under control.
The guideline makes eight recommendations:
Drug therapy initiation

R1: BP threshold for R2 & 3: Whether R4: Which drug(s) to

starting drug treatment screening and assessment prescribe
Those with diagnosis of HTN are needed before Any of these drug classes:
and BP of ≥140/≥90 mmHg treatment is started diuretics/ACEi,
Those with CVD and Obtain tests to screen for ARB/CCBs
SBP ≥130–139 mmHg comorbidities and Recommendation: strong
conduct CV risk assessment Evidence: high certainty
Recommendation: strong
Evidence: moderate–high certainty but only if it doesn’t R5: Combination therapy
Those without CVD but delay treatment To improve adherence and
with high CVD risk, Recommendation: conditional persistence combination
diabetes, CKD and Evidence: low certainty
therapy recommended
SBP ≥130–139 mmHg preferably in a single pill
Recommendation: conditional Recommendation: conditional
Evidence: moderate–high certainty Evidence: moderate certainty

Targets and follow-up

R6: BP target for R7: Follow-up intervals R8: Use of nonphysician

control of HTN Monthly HCWs in further
140/90 mmHg follow up management of HTN
in those without comorbidities until patient reaches target BP Treatment can be provided by
SBP 130 mmHG Recommendation: conditional nonphysician
in those with CVD Evidence: low certainty professionals
Recommendation: strong 3–6 month as long as they are given
Evidence: moderate certainty training, prescribing authority,
follow up
SBP <130 mmHg once target BP is reached management protocols and
in those with high CVD risk, Recommendation: conditional physician oversight
diabetes and CKD Evidence: low certainty Recommendation: conditional
Recommendation: conditional Evidence: low certainty
Evidence: moderate certainty

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