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Title: Clinical perspective on antihypertensive drug treatment in adults with grade 1 hypertension and low-to-moderate cardiovascular risk: an international expert consultation
Austin Authors: Morales Salinas, Alberto;Coca, Antonio;Olsen, Michael H;Sanchez, Ramiro A;Sebba-Barroso, Weimar K;Kones, Richard;Bertomeu-Martinez, Vicente;Sobrino, Javier;Alcocer, Luis;Pineiro, Daniel J;Lanas, Fernando;Machado, Carlos A;Aguirre-Palacios, Fernando;Ortellado, Jose;Perez, Gonzalo;Sabio, Rodrigo;Landrove, Orlando;Rodriguez-Leyva, Delfin;Duenas-Herrera, Alfredo;Rodriguez Portellesr, Ayelen;Parra-Carrillo, Jose Z;Piskorz, Daniel L;Bryce-Moncloa, Alfonso;Waisman, Gabriel;Yano, Yuichiro;Hector, Ventura;Orias, Marcelo;Prabhakaran, Dorairaj;Sundström, J;Wang, Jiguang;Burrell, Louise M ;Schutte, Alta E;Lopez-Jaramillo, Patricio;Eduardo, Barbosa;Redon, Josep;Weber, Michael A;Lavie, Carl J;Ramirez, Agustin;Ordunez, Pedro;Yusuf, Salim;Zanchetti, Alberto
Affiliation: Cardiocentro "Ernesto Che Guevara", Santa Clara, Cuba
Unidad de Hipertension y Riesgo Vascular, Hospital Clínic (IDIBAPS), Universidad de Barcelona, España
Department of Internal Medicine, Holbaek Hospital, and Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Denmark
Hipertension Arterial y Unidad Metabólica, Hospital Universitario, Fundación Favaloro, Argentina
Hypertension League - Federal University of Goias-Brasil
Director, Cardiometabolic Research Institute, Houston, Texas, USA
Hospital Universitario de San Juan, Alicante-Valencia, España
Fundació Hospital de l'EsperitSant, Barcelona, España
Instituto Mexicano de Salud Cardiovascular, Mexico
Universidad de Buenos Aires, Buenos Aires, Argentina
Universidad de la Frontera, Chile
Ministerio de Salud/Muncipal Health Office Campos do Jordão, Brasil
Clínica Kennedy, Guayaquil, Ecuador
Ministerio de Salud, Paraguay
Clínica Olivos, Buenos Aires, Argentina
Hospital de Alta Complejidad, Santa Cruz, Argentina
Ministerio de Salud Pública, Cuba
Universidad Médica de Holguín, Cuba
Instituto de Cardiologia y Cirugia Cardiovascular, Habana, Cuba
Universidad de Guadalajara, México
Instituto de Cardiología, Sanatorio Británico, Rosario, Argentina
Hospital Italiano de Buenos Aires, Argentina
The University of Mississippi Medical Center, USA
Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, USA
Sanatorio Allende y Universidad Nacional de Cordoba, Argentina
Public Health Foundation of India and Centre for Chronic Disease Control, Haryana, India
Department of Medical Sciences, Uppsala University, and Uppsala Clinical Research Center, Uppsala, Sweden
The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
Department of Medicine. The University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
South African Medical Research Council Unit on Hypertension and Cardiovascular Disease, Hypertension in Africa Research Team,North-West University, South Africa
Research Institute, Fundación Oftalmológica de Santander and Medical School, Universidad de Santander, Colombia Colombia and Universidad Tecnologica Equinoccial, Facultad de Medicina Eugenio Espejo, Ecuador
H.Moinhos de Vento Porto Alegre, Brasil
Universidad de Valencia, España
Division of Cardiovascular Medicine, State University of New York, Downstate College of Medicine, New York
Hipertension Arterial y Unidad Metabólica, Hospital Universitario, Fundación Favaloro, Argentina; Instituto de Medicina Traslacional, Trasplante y Bioingenieria. Universidad Favaloro-CONICET, Argentina
Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization.Washington, USA
Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Canada
Istituto Auxologico Italiano, Centro Interuniversitario di Fisiologia Clinica e Ipertensione, University of Milan, Italia
Issue Date: Jul-2017 2017-03-08
Publication information: Current Problems in Cardiology 2017; 42(7): 198-225
Abstract: Hypertension is a leading risk factor for disease burden globally. An unresolved question is whether grade 1 hypertension (140-159/90-99mmHg) with low (cardiovascular mortality <1% at 10 years) to moderate (cardiovascular mortality ≥1% and <5% at 10 years) absolute total cardiovascular risk (CVR) should be treated with antihypertensive agents. A virtual international consultation process was undertaken to summarize the opinions of select experts. After holistic analysis of all epidemiological, clinical, psychosocial, and public health elements, this consultation process reached the following consensus in hypertensive adults aged <80 years: (1) The question of whether drug treatment in grade 1 should be preceded by a period of some weeks or months during which only lifestyle measures are recommended cannot be evidence based, but the consensus opinion is to have a period of lifestyle alone reserved only to patients with grade 1 "isolated" hypertension (grade 1 uncomplicated hypertension with low absolute total CVR, and without other major CVR factors and risk modifiers). (2) The initiation of antihypertensive drug therapy in grade 1 hypertension with moderate absolute total CVR should not be delayed. (3) Men ≥55 years and women ≥60 years with uncomplicated grade 1 hypertension should automatically be classified within the moderate absolute total CVR category, even in the absence of other major CVR factors and risk modifiers. (4) Statins should be considered along with blood-pressure lowering therapy, irrespective of cholesterol levels, in patients with grade 1 hypertensive with moderate CVR.
DOI: 10.1016/j.cpcardiol.2017.03.001
ORCID: 0000-0003-1863-7539
PubMed URL:
Type: Journal Article
Appears in Collections:Journal articles

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