What is new in the 2018 Chinese hypertension guideline and the implication for the management of hypertension in Asia?

Wang, Tzung‐Dau; Chia, Yook Chin; Chen, Chen Huan; Park, Sungha; Hoshide, Satoshi; Tomitani, Naoko; Kabutoya, Tomoyuki; Shin, Jinho; Turana, Yuda; Soenarta, Arieska Ann; Tay, Jam Chin; Buranakitjaroen, Peera; Nailes, Jennifer; Minh, Huynh Van; Siddique, Saulat; Sison, Jorge; Sogunuru, Guru Prasad; Sukonthasarn, Apichard; Teo, Boon Wee; Verma, Narsingh

doi:10.1111/jch.13803

Cited by 21 publications

(15 citation statements)

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“…The HOPE Asia Network has published a number of papers on important Asia‐specific topics in hypertension . This Asia‐specific issue of the Journal of Clinical Hypertension provides an important resource including original research and review articles on the management of hypertension from a variety of Asian viewpoints, including topics such as central BP, environmental factors, comorbidities such as diabetes, atrial fibrillation, heart failure, and dementia, recent Asian guidelines and so forth . This issue also includes reports from twelve countries/regions in Asia to help define and highlight the current status of hypertension, its management, and their initiatives.…”

Section: Resultsmentioning

confidence: 99%

“…The “perfect 24‐hour BP control” strategy taking Asian characteristics into account is essential for achievement of the “zero” cardiovascular event goal . Considerable work has already been done on the journey to achieving this goal . Practically, a staged approach to the 24‐hour management of hypertension should be considered, first targeting morning hypertension, then nocturnal hypertension, followed by daytime hypertension .…”

Section: Perspectivesmentioning

confidence: 99%

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The HOPE Asia Network activity for “zero” cardiovascular events in Asia: Overview 2020

Kario

2020

J of Clinical Hypertension

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The impact of hypertension-related cardiovascular disease and target organ damage, and therefore the benefits of blood pressure (BP) control, is greater in Asian than in Western countries. Asia-specific features of hypertension and its effective management are important and active areas of research. The Hypertension Cardiovascular Outcome Prevention and Evidence in Asia (HOPE Asia) Network was formed in 2016and is now a member of the World Hypertension League. The main goal of the HOPE Asia Network is to improve the management of hypertension and organ protection toward achieving "zero" cardiovascular events in Asia. Considerable work has already been done on the journey to achieving this goal. We have shown that BP control status in Asia differs between countries, and even between regions within the same country. Several expert panel consensus recommendations and clinical guidance papers are available to support the use of home and ambulatory BP monitoring in the region. In addition, the AsiaBP@Home study prospectively investigated home BP control status across 15 specialist centers using the same validated device and measurement schedule. We have also proposed the concept of systemic hemodynamic atherothrombotic syndrome (SHATS), a vicious cycle of BP variability and vascular disease on cardiovascular events and organ damage, and suggested a SHATS score for risk stratification for clinical practice. This special issue of the journal collates Asia-specific resources and data, contributing to advances in hypertension management and cardiovascular disease prevention in the region.

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Section: Resultsmentioning

confidence: 99%

Section: Perspectivesmentioning

confidence: 99%

The HOPE Asia Network activity for “zero” cardiovascular events in Asia: Overview 2020

Kario

2020

J of Clinical Hypertension

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“…The exposure of interest was hypertension. Hypertension was defined as systolic blood pressure (SBP) values ≥140 mmHg and/or diastolic blood pressure (DBP) values ≥90 mmHg [21][22][23]. Blood pressure was measured by trained staff using standard mercury sphygmomanometers.…”

Section: Exposure Of Interest and Covariatesmentioning

confidence: 99%

Association of hypertension and incident diabetes in Chinese adults: a retrospective cohort study using propensity-score matching

Chen

et al. 2020

Preprint

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Background Previous studies have revealed that hypertension is one of major risk factors of incident diabetes. However, reliable quantification of the relationship between hypertension and diabetes risk is limited, especially in Chinese people. We aimed to investigate the association between hypertension and risk of incident diabetes in a large cohort of Chinese population. Methods This was a retrospective propensity score-matched cohort study. We enrolled 211809 Chinese adults without diabetes at baseline between 2010 and 2016. The target independent and dependent variable were hypertension at baseline and incident diabetes during follow-up respectively. The one to one propensity score matching using a non-parsimonious multivariable logistic regression was conducted to balance the confounders between 28,946 hypertensive patients and 28,946 non-hypertensive participants. The doubly robust estimation method was used to investigate the association between hypertension and incident diabetes. Result After propensity-score matching, the cumulative incidence of diabetes among hypertensive and non-hypertensive participants were 1627.690 per 100,000 person-years and 1414.422 per 100,000 person-years, respectively. In the propensity-score matching cohort, compared to the non-hypertensive participants, the risk of incident diabetes increased by 14.0% among hypertensive subjects (HR = 1.140, 95% confidence interval (CI): 1.058–1.229, P = 0.00063). After adjusting for the demographic and clinical covariates, diabetes risk increased by 13.1% in the hypertensive group (HR = 1.131, 95%CI: 1.049–1.220, P = 0.00143). And diabetes risk increased by 15.4% among hypertensive subjects after adjusting for the propensity score (HR = 1.154, 95%CI:1.070–1.244, P = 0.00019).In the subgroup analysis, compared to non-hypertensive participants with low propensity score, the risk of incident diabetes increased by 2.6 times among hypertensive patients with high propensity score (HR = 3.610,95%CI: 2.604–5.005,P < 0.00001). In the sensitivity analysis, the risk of diabetes in the hypertensive group increased by 11.7% in the original cohort (HR = 1.117༌95%CI: 1.044–1.196,P = 0.00134) and 19.9% in the weighted cohort(HR = 1.199༌95%CI: 1.149–1.250,P < 0.00001), respectively. Conclusion Hypertension was associated with a 13.1% increase in the risk of developing diabetes in Chinese adults. Additionally, compared to non-hypertensive participants with low propensity score, the risk of incident diabetes increased by 2.6 times among hypertensive patients with high propensity score.

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“…The prevalence of hypertension is increasing worldwide [ 1 ]. Adequate control of blood pressure (BP) is therefore of paramount importance [ 2 ]. A high BP is associated with a higher risk of developing myocardial infarction, heart failure, stroke, and kidney disease [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of ARB/HCTZ Combination Therapy in Uncontrolled Hypertensive Patients Compared with ARB Monotherapy: A Meta-Analysis

Zheng

Yan

et al. 2021

International Journal of Hypertension

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Objective. To evaluate the efficacy of combination of angiotensin receptor blocker (ARB) with hydrochlorothiazide (HCTZ) compared to ARB alone in patients with uncontrolled hypertension via a systematic review and meta-analysis. Methods. We searched databases till July 2019 using relevant search terms. We included articles that were randomised controlled trials (RCTs) comparing ARB/HCTZ with ARB for a duration of at least 4 weeks and reported on the efficacy or safety. Meta-analyses for efficacy outcomes were performed. In addition, groups given different concentrations of HCTZ (12.5 and 25 mg) were analysed separately. Results. Sixteen RCTs (12,055 participants) were included. Overall, ARB/HCTZ combination therapy (both 12.5 and 25 mg HCTZ combination) resulted in better sitting systolic and diastolic blood pressure control than ARB alone (mean difference (95% confidence interval (CI): −5.69 [−6.66, −4.73] for 12.5 mg and −9.10 [−11.78, −6.42] for 25 mg and mean difference (95% CI): −2.91 [−3.31, −2.51] for 12.5 mg and −4.16 [−4.75, −3.58] for 25 mg). ARB/HCTZ combination therapy resulted in a higher rate of target blood pressure achievement compared to ARB alone (risk ratio (95% CI): 1.50 [1.42, 1.59]). ARB/HCTZ combination therapy had similar rates of total adverse events (AEs) and severe AEs compared to ARB alone. Conclusion. ARB/HCTZ combination therapy is more efficacious for controlling blood pressure, and combination with a low concentration of HCTZ has similar AEs compared to ARB alone. Clinicians should consider adding HCTZ in the medication regime of patients with uncontrolled hypertension using ARB, if their clinical profile allows.

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What is new in the 2018 Chinese hypertension guideline and the implication for the management of hypertension in Asia?

Abstract: The new Chinese hypertension guideline comprehensively covers almost all major aspects in the management of hypertension. In this new guideline, hypertension remains defined as a systolic/diastolic blood pressure of at least 140/90 mm Hg. For

Cited by 21 publications

References 28 publications

The HOPE Asia Network activity for “zero” cardiovascular events in Asia: Overview 2020

The HOPE Asia Network activity for “zero” cardiovascular events in Asia: Overview 2020

Association of hypertension and incident diabetes in Chinese adults: a retrospective cohort study using propensity-score matching

Efficacy of ARB/HCTZ Combination Therapy in Uncontrolled Hypertensive Patients Compared with ARB Monotherapy: A Meta-Analysis

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