Division of Nephrology and Hypertension, Department of Internal Medicine, Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Ann Med. 2022 Dec;54(1):837-845. doi: 10.1080/07853890.2022.2044510.
The global burden of hypertension remains an unsolved problem, especially in low- and middle-income countries (LMICs). For this reason, clinical practice guidelines containing the latest evidence-based recommendations are crucial in the management of hypertension. It is noteworthy that guidelines simply translated from those of high-income countries (HICs) are not the solution to the problem of hypertension in LMICs. Among the numerous guidelines available, those of the World Health Organisation and the International Society of Hypertension are the latest to be published as of the writing of this article. In this review, we conducted both general and specific comparisons between the recommendations supplied by both guidelines. Differences in aspects of hypertension management such as the timing of antihypertensive initiation, assessment of comorbidities and cardiovascular risk factors, pharmacological therapy selection, and blood pressure target and reassessment are explored. Lastly, the implications of the differences found between the two guidelines in both LMICs and HICs are discussed.Key messagesCurrently, with low treatment and control rates, hypertension remains a burden in low- and middle-income countries (LMICs).The lack of customised guidelines for LMICs cannot be solved simply by adopting guidelines from high-income countries.The World Health Organisation (WHO) recently published a clinical guideline for the pharmacological management of hypertension in LMICs. We compare select recommendations from the guidelines to those published by the International Society of Hypertension.
全球高血压负担仍然是一个未解决的问题,特别是在中低收入国家(LMICs)。出于这个原因,包含最新循证建议的临床实践指南在高血压管理中至关重要。值得注意的是,简单地将来自高收入国家(HICs)的指南翻译过来并不能解决 LMICs 高血压问题。在众多可用的指南中,截至本文撰写之时,世界卫生组织和国际高血压学会的指南是最新发布的。在这篇综述中,我们对这两个指南提供的建议进行了一般和具体的比较。探讨了高血压管理方面的差异,如降压治疗的开始时间、合并症和心血管危险因素的评估、药物治疗选择以及血压目标和重新评估。最后,讨论了这两个指南之间的差异在 LMICs 和 HICs 中的影响。
目前,由于治疗和控制率低,高血压仍然是中低收入国家(LMICs)的负担。
中低收入国家不能简单地通过采用高收入国家的指南来解决缺乏针对这些国家的定制指南的问题。
世界卫生组织(WHO)最近发布了一份针对中低收入国家高血压药物治疗管理的临床指南。我们将指南中的一些选定建议与国际高血压学会发布的建议进行了比较。