HYPERTENSION UPDATE 2019- CME BY DR ANIRBAN BISWAS
Fri, 20:00 – 23:00ON 23 RD AUGUST 2019
AT THE MUSE SAROVAR PORTICO
A-1, CHIRAG ENCLAVE , NEHRU PLACE
SPEAKER: DR ANIRBAN BISWAS MD ( GOLD MEDALIST)
PROFESSIONAL MEMBER EUROPEAN SOCIETY OF CARDIOLOGY
PROGRAM CHAIR CARDIOLOGY - TEXILA AMERICAN UNIVERSITY
SUMMARY OF HTN UPDATE 2019 WITH REFERENCE TO AHA GUIDELINES
The latest AHA (american heart association ) guidelines suggests that High blood pressure should be treated earlier with lifestyle changes and in some patients with medication – at 130/80 mm Hg rather than 140/90 – as per DR anirban biswas - preventive cardiologist and diabetologist & professional member of European society of cardiology (ESC)
The new guidelines – the first comprehensive set since 2003 – lower the definition of high blood pressure to account for complications that can occur at lower numbers and to allow for earlier intervention. The new definition will result in nearly half of the U.S. adult population (46 percent) having high blood pressure, with the greatest impact expected among younger people. Additionally, the prevalence of high blood pressure is expected to triple among men under age 45, and double among women under 45, the guideline authors note.
However, only a small increase is expected in the number of adults requiring anti-hypertensive medication."You've already doubled your risk of cardiovascular complications compared to those with a normal level of blood pressure," said Paul K. Whelton, MB, MD, MSc, FACC, lead author of the guidelines. "We want to be straight with people – if you already have a doubling of risk, you need to know about it. It doesn't mean you need medication, but it's a yellow light that you need to be lowering your blood pressure, mainly with non-drug approaches."
Blood pressure categories in the new guideline are:
Normal: Less than 120/80 mm Hg;
Elevated: Systolic between 120-129 and diastolic less than 80;
Stage 1: Systolic between 130-139 or diastolic between 80-89;
Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.
SALIENT FEATURES OF NEW GUIDELINES
1. The guidelines eliminate the category of prehypertension, categorizing patients as having either Elevated (120-129 and less than 80) or Stage I hypertension (130-139 or 80-89).
2. While previous guidelines classified 140/90 mm Hg as Stage 1 hypertension, this level is classified as Stage 2 hypertension under the new guidelines.
3. In addition, the guidelines stress the importance of using proper technique to measure blood pressure; recommend use of home blood pressure monitoring using validated devices; and highlight the value of appropriate training of health care providers to reveal "white-coat hypertension."
4. Other changes include:Only prescribing medication for Stage I hypertension if a patient has already had a cardiovascular event such as a heart attack or stroke, or is at high risk of heart attack or stroke based on age, the presence of diabetes mellitus, chronic kidney disease or calculation of atherosclerotic risk (using the same risk calculator used in evaluating high cholesterol).
5. Recognizing that many people will need two or more types of medications to control their blood pressure, and that people may take their pills more consistently if multiple medications are combined into a single pill.
6. Identifying socioeconomic status and psychosocial stress as risk factors for high blood pressure that should be considered in a patient's plan of care.