The
global hypertension prevalence is estimated to increase from 40% to 50% in the
year 2025, with a significant upsurge in future morbidity and mortality due to
heart disease and strokes. In the Kingdom of Bahrain, hypertension control has
been achieved in only 1 out of 6 treated patients, which suggests that there is
a major shortcoming either in clinician inertia or failure to take appropriate
action to drive blood pressures ("BPs") down to guidelinerecommended
levels.
We
suggest that clinicians and the Ministry of Health ought to select one of the
current guidelines and follow its recommendations. The Joint National Committeefor Hypertension Detection and Management updated the JNC 8 guideline (2013),
which if followed correctly, will achieve enhanced patient management and
improve outcome indicators. The JNC 8 panel has a different, focused and more
simplified treatment approach than other expert panels, with a single BP
recommendation (140/90 mm Hg) for both the pharmacologic treatment threshold
and treatment goal for patients between the ages of 18 to 60 years old
with/without diabetes ("DM") or chronic kidney disease
("CKD"). Furthermore, the JNC 8 relies solely on critical assessment
of randomized controlled trials and reduces the number of first-line drugs from
five to four. Nonetheless, guidelines are not a substitute for clinical
judgment, and clinicians must consider each patient's circumstances and
clinical condition when making decisions about medical care. Read more.............
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