Clinical Practice Guidelines for the Management of Hypertension in the Community

Abstract

These guidelines have been written to provide a straight-forward approach to managing hypertension in the community. We have intended that this brief curriculum and set of recommendations be useful not only for primary care physicians and medical students, but for all professionals who work as hands-on practitioners. We are aware that there is great variability in access to medical care among communities. Even in so-called wealthy countries there are sizable communities in which economic, logistic, and geographic issues put constraints on medical care. And, at the same time, we are reminded that even in countries with highly limited resources, medical leaders have assigned the highest priority to supporting their colleagues in confronting the growing toll of devastating strokes, cardiovascular events, and kidney failure caused by hypertension. Our goal has been to give sufficient information to enable health care practitioners, wherever they are located, to provide professional care for people with hypertension. All the same, we recognize that it will often not be possible to carry out all of our suggestions for clinical evaluation, tests, and therapies. Indeed, there are situations where the most simple and empir-ical care for hypertension—simply distributing whatever antihypertensive drugs might be available to people with high blood pressure—is better than doing nothing at all. We hope that we have allowed sufficient flexibility in this statement to enable responsible clini-cians to devise workable plans for providing the best possible care for patients with hypertension in their communities. We have divided this brief document into the follow-ing sections: