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

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Chapter 8.Component 3: Clinical Care Of Adults With Hypertension8.3.1 Individual with uncomplicated hypertensionRecommendationsThe goal of therapy for simple hypertensive patients is bloodpressure below 140/ 90 mm Hg.ASupporting evidence●●The Hypertension Optimal Treatment (HOT) trial showed thatthe optimal target blood pressure in patients with a diastolicblood pressure of 100-115 mmHg was 139/83 mmHg 24 .1++8.3.2 Patient with hypertension and diabetesRecommendationsTarget blood pressure is below 130/80 mmHg.ASupporting evidence●●●●Patients with hypertension and type 2 diabetes in the tighterblood pressure control group had far fewer cardiovascular system(CVS) events than those at the less tight control group 24 .The subgroup of diabetes patients randomised to lowest diastolicblood pressure group (
Chapter 8.Component 3: Clinical Care Of Adults With Hypertension8.3.3 Patient with hypertension and chronic kidney diseasesRecommendationsTarget blood pressure is below 130/80 mmHg.ASupporting evidence●●●●●●Patients with chronic kidney disease in the low target bloodpressure group had a significantly slower reduction in glomerularfiltration rate (GFR) decline compared with patients assigned tothe high target blood pressure group 25 .The risks for kidney failure and the composite outcome ofkidney failure and all-cause mortality were significantly lower inthe low target blood pressure group 26 .Systolic blood pressure range of 110-129 mmHg was associatedwith the lowest risk of kidney disease progression in patientswith urine protein excretion > 1g/day 27 .1++1++1++8.4 Follow up and monitoringAfter initiating antihypertensive drug treatment, most patients should be followedup within 2 weeks until the blood pressure goal is achieved. More frequentvisits may be indicated for patients with systolic blood pressure ≥ 160mmHg ordiastolic blood pressure ≥ 100mgHg or with complications.Once the blood pressure goal is achieved, the follow-up interval may be extendedto 6-12 weeks depending on the patient’s condition and the doctor’s assessment.HK Reference Framework for Hypertension Care for Adults in Primary Care Settings16
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 72 and 73:
Module 7Drug Treatment for People w
Page 74 and 75:
Module 8Annual AssessmentLaboratory
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