2010 Hong Kong Reference Framework for Hypertension Care for ...

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Chapter 8.Component 3: Clinical Care Of Adults With Hypertension8.2.1.6 Stop smokingRecommendationsEncourage all hypertensive patients to stop smoking.ASupporting evidence●●●●Smoking cessation is the most effective, immediate way toreduce cardiovascular risk. The pressor effect of smokingcould be partly responsible for the major increase in stroke andcoronary disease among smokers, as well as for the apparentresistance to antihypertensive therapy 18,19 .Smoking exerts a major pressor effect on ambulatory bloodpressure monitoring 20 . The use of smokeless tobacco and cigarsmay also raise blood pressure 21 . Smoking cessation could reducethe overall cardiovascular risk as there was a clear dose-responserelationship between the number of cigarettes smoked per dayand risk of developing both coronary heart disease and stroke 22 .1++1++2++If assistance is needed, please refer to Appendix 1 for more information onsmoking cessation services.13 HK Reference Framework for Hypertension Care for Adults in Primary Care Settings
Chapter 8.Component 3: Clinical Care Of Adults With Hypertension8.2.2 Drug treatmentTherapy begins with lifestyle modification, and if blood pressure goal is notachieved, drug treatment must often be considered in addition. The choice of drugtreatment should take into account the specific indications and contraindications.(Module 7)RecommendationsConsider to start drug treatment in patients with sustainedsystolic blood pressures ≥ 140mmHg or diastolic blood pressures≥ 90mmHg despite lifestyle modification for 6 months or iftarget organ damage is present.ASupporting evidence●●The Hypertension Optimal Treatment (HOT) randomised trialshowed that intensive lowering of blood pressure in patients withhypertension was associated with a low rate of cardiovascularevents 23 .1++8.3 Target values for blood pressure loweringThe relationship between blood pressure and cardiovascular risk is continuous.In general, the higher the risk of the individual patient, the more aggressive bloodpressure lowering is indicated.HK Reference Framework for Hypertension Care for Adults in Primary Care Settings14
Page 2: ContentPreface.....................
Page 6 and 7: Key To Evidence Statements And Grad
Page 8 and 9: Chapter 1.EpidemiologyHypertension
Page 12 and 13: Chapter 6.Component 1: Prevention O
Page 14 and 15: Chapter 7.Component 2: Early Identi
Page 16 and 17: Chapter 8.Component 3: Clinical Car
Page 26 and 27: Chapter 9.Component 4: Patient Empo
Page 28 and 29: Appendix 1. Smoking Cessation Servi
Page 30 and 31: AcknowledgmentsDr CHU Leung-wingDr
Page 32 and 33: AcknowledgmentsDr CHAN Wai-manDr Jo
Page 34 and 35: AcknowledgmentsDr Betty YOUNG Wan-y
Page 36 and 37: AcknowledgmentsProfessor YU Cheuk-m
Page 38 and 39: Reference10. Sacks FM, Svetkey LP,
Page 40 and 41: Module 1 Framework for Population A
Page 42 and 43: Module 1Framework for Population Ap
Page 44 and 45: Module 2Blood Pressure Measurement2
Page 46 and 47: Module 2Blood Pressure Measurement4
Page 48 and 49: Module 3 Secondary Hypertension 1,2
Page 50 and 51: Module 4Evaluation for All Newly Di
Page 52 and 53: Module 4Evaluation for All Newly Di
Page 54 and 55: Module 5Dietary InterventionFood Gr
Page 56 and 57: Module 5Dietary InterventionMeals a
Page 58 and 59: Module 5Dietary InterventionReferen
Page 60 and 61: Module 6Exercise Recommendations to
Page 66 and 67: Module 7Drug Treatment for People w
Page 68 and 69: Module 7Drug Treatment for People w
Page 70 and 71:
Module 7Drug Treatment for People w
Page 72 and 73:
Module 7Drug Treatment for People w
Page 74 and 75:
Module 8Annual AssessmentLaboratory
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2010 Hong Kong Reference Framework for Hypertension Care for ...

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