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Feature Article

Hypertension: practical implications of the new National Heart Foundation guidelines

OMAR AZZAM, HAMISH PROSSER, Markus Schlaich

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Abstract

The 2016 National Heart Foundation guidelines for diagnosis and management of hypertension in adults address primary and secondary prevention. They target absolute cardiovascular risk and focus on contemporary management of hypertension in the context of an ageing population.

Key Points

  • Validated, regularly maintained, nonmercury sphygmomanometers are recommended for blood pressure (BP) measurement.
  • Out-of-clinic BP measurement using home or 24-hour ambulatory measurement is a stronger predictor of outcome than clinic BP measurement.
  • Automated clinic BP measurement provides similar readings to home and ambulatory BP measurement, and results are generally lower than those from conventional clinic BP measurement.
  • BP-lowering therapy is beneficial (i.e. resulting in reduced stroke, cardiovascular death and all-cause mortality) for patients with uncomplicated mild hypertension.
  • For patients with at least moderate cardiovascular risk, lower systolic BP targets of less than 120 mmHg (using automated clinic BP measurement) provide benefit with some increase in treatment-related adverse effects.
  • Selection of a BP target should be based on informed, shared decision making between patients and health care providers, considering the benefits and harms, and reviewed on an ongoing basis.

    Picture credit: © Image Source/HBSS/Diomedia.com
    Model used for illustrative purposes only

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