Which hypertension guideline and threshold values? New thresholds in hypertension

Abstract

In November 2017, hypertension (HT) thresholds were lowered according to the new guidelines published by the American College of Cardiology/American Heart Association (ACC/AHA). Previously 140/90 mmHg and above values were described as hypertension; 130-139 mmHg systolic or 80-89 mmHg diastolic values are classified as Stage 1 HT by the new guideline. BP values known as prehypertension were classified as Stage 1 to prevent the development of cardiovascular events. The importance of out-of-office BP measurement values and taking the average of multiple measurements were emphasized. Shaping the treatment based on underlying cardiovascular risk and combining with lifestyle changes were stated. Despite the recommendations of the new guideline, some clinicians have hesitations to apply the new classification in daily practice. Physcians concerns include increased medication costs by lowering BP values, treatment compliance problems, complications primarily experienced in elderly patients and anxiety. Despite the large number of published HT guidelines, the main determinant in treatment management is considered to be a patient-centered holistic approach of which is one of the most important characteristics of the family medicine.