B-QuiCK: Hypertension

Hypertension management: B-QuiCK

Is antihypertensive treatment required?

Patients with a blood pressure of ≥ 160/100 mmHg should be initiated on antihypertensive treatment immediately, in addition to lifestyle changes, regardless of their five-year CVD risk.

For all other patients with a blood pressure persistently ≥ 130/80 mmHg, the 2018 Ministry of Health cardiovascular risk consensus statement recommends calculating their five-year CVD risk to guide antihypertensive medicine decisions. In patients with:

• Five-year CVD risk < 5%: antihypertensive treatment is not recommended; proceed with lifestyle changes
• Five-year CVD risk 5 – 15%: consider antihypertensive treatment if blood pressure is ≥ 140/90 mmHg, in addition to lifestyle changes
• Five-year CVD risk ≥ 15%: antihypertensive treatment is recommended, in addition to lifestyle changes

Summary: approach to antihypertensive treatment of patients with uncomplicated hypertension in primary care. N.B. Co-morbidities can influence the selection of approach to antihypertensive use. See the full article for more information.

^* Blood pressure should be monitored at least every four-to-six weeks during medicine titration until blood pressure targets have been achieved. The frequency of follow-up in the long-term depends on a range of patient-specific factors, e.g. the severity of hypertension in the context of the patient’s overall CVD risk.

^†Such as a beta-blocker or an alpha-blocker

Targets for the treatment of hypertension