Hypertension Pharmacological Treatment in Adults: A World Health Organization Guideline Executive Summary

Abstract

Hypertension is a major cause of cardiovascular disease and deaths worldwide especially in low- and middle-income countries. Despite the availability of safe, well-tolerated, and cost-effective blood pressure (BP)-lowering therapies, <14% of adults with hypertension have BP controlled to a systolic/diastolic BP <140/90 mm Hg. We report new hypertension treatment guidelines, developed in accordance with the World Health Organization Handbook for Guideline Development. Overviews of reviews of the evidence were conducted and summary tables were developed according to the Grading of Recommendations, Assessment, Development, and Evaluations approach. In these guidelines, the World Health Organization provides the most current and relevant evidence-based guidance for the pharmacological treatment of nonpregnant adults with hypertension. The recommendations pertain to adults with an accurate diagnosis of hypertension who have already received lifestyle modification counseling. The guidelines recommend BP threshold to initiate pharmacological therapy, BP treatment targets, intervals for follow-up visits, and best use of health care workers in the management of hypertension. The guidelines provide guidance for choice of monotherapy or dual therapy, treatment with single pill combination medications, and use of treatment algorithms for hypertension management. Strength of the recommendations was guided by the quality of the underlying evidence; the tradeoffs between desirable and undesirable effects; patient’s values, resource considerations and cost-effectiveness; health equity; acceptability, and feasibility consideration of different treatment options. The goal of the guideline is to facilitate standard approaches to pharmacological treatment and management of hypertension which, if widely implemented, will increase the hypertension control rate world-wide.

A high triglyceride to high-density lipoprotein cholesterol ratio is associated with poor renal outcome in IgA nephropathy patients

“…The TG/HDL-C ratio was obtained by dividing the serum triglyceride level by the plasma high-density lipoprotein cholesterol level. Hypertension was de ned as blood pressure > 140/90 mmHg or the use of antihypertensive agents [12]. eGFR was calculated using the CKD-EPI equation [13].…”

Hypertriglyceridemia May be a Key Independent Predicting Factor for Gallbladder Cancer Risk in Gallbladder Stone Disease Patients: A Case-Control Study

“…Hypertension was diagnosed by cardiovascular specialist based on guidelines for pharmacological treatment of hypertension in adults published by the World Health Organization (WHO), for example, SBP ≥ 140mmHg or DBP ≥ 90mmHg were diagnosed as hypertension in the newest edition (14). Homeostasis model assessment-insulin resistance (HOMA-IR) was calculated from fasting glucose and insulin.…”

Elevated Serum Triglyceride Levels May be a Key Independent Predicting Factor for Gallbladder Cancer Risk in Gallbladder Stone Disease Patients: a Case-control Study

“…Determination of diabetes, hypertension, hypertriglyceridemia and insulin resistance Diabetes diagnosis was completed by a professional endocrinologist according to the latest China diagnostic criteria: for example, the newest diabetes patients were diagnosed by Guideline for prevention and treatment of type 2 diabetes mellitus in China 2020 (13). Hypertension was diagnosed by cardiovascular specialist based on guidelines for pharmacological treatment of hypertension in adults published by the World Health Organization (WHO), for example, SBP ≥ 140mmHg or DBP ≥ 90mmHg were diagnosed as hypertension in the newest edition (14). Homeostasis model assessment-insulin resistance (HOMA-IR) was calculated from fasting glucose and insulin.…”