Primary care nurses should aim to get blood pressure to 140/90mmHg in virtually all patients, according to major new guidelines in preventing and treating hypertension.
Updated guidelines were published last week by the European Society of Hypertension and the European Society of Cardiology, replacing a 2007 version.
The guidance state that lifestyle changes are the “cornerstone for the prevention of hypertension”, including reduction of salt and alcohol, maintaining a healthy body weight, regular exercise and the elimination of smoking.
Additionally, it calls for greater awareness that hypertension can be treated, highlighting poor understanding among patients of its impact and poor long-term adherence to drug therapy.
A “major development”, the guidance said, was the decision to recommend a single systolic blood pressure target of 140mmHg for almost all patients, regardless of risk.
This replaces the 2007 targets of 140/90mmHg for moderate-to-low risk patients, and 130/80mmHg for high-risk patients. There was insufficient evidence to justify two targets, the guideline authors said.
A diastolic target of 90mmHg is always recommended, except in patients with diabetes where values 85 mmHg are recommended, the guidance added.
The updated guidance also notes the increasing role of home blood pressure monitoring and provides new guidance on how and when to take anti-hypertensive drugs.
It also emphases the need to assess hypertension patients for all cardiovascular risk factors, such as organ damage and diabetes.
Professor Giuseppe Mancia, co-chair of the group that developed the guidelines, said: “This is certainly the most important current overview to consider the totality of hypertension treatment. It will form the basis of hypertension care for the foreseeable future.”
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