Document Detail


Controversies in blood pressure goal guidelines and masked hypertension.
MedLine Citation:
PMID:  22548577     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
In uncomplicated hypertension, <140/90 mmHg is the treatment goal for individuals aged 18-79 and between 140 mmHg and 150 mmHg in those 80 years of age. Inhibitors of the renin-angiotensin-aldosterone system, as well as calcium channel blockers, are universally accepted as first-line therapy in uncomplicated hypertension, but controversy exists over the role of thiazide diuretics and beta blockers. Because at similar blood pressure (BP) levels, African Americans have more target organ damage than whites, a lower goal of <135/85 mmHg is recommended. In patients with coronary artery disease, diabetes, and chronic kidney disease, <130/80 mmHg is recommended. Masked hypertension, defined as normal clinic BP with a high average self-monitored or ambulatory BP, is prevalent in those with chronic kidney disease, diabetes, and obstructive sleep apnea. Masked hypertension is associated with worse outcome. Ambulatory BP monitoring for those at risk for masked hypertension needs to be incorporated into guidelines.
Authors:
Robert A Phillips
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of the New York Academy of Sciences     Volume:  1254     ISSN:  1749-6632     ISO Abbreviation:  Ann. N. Y. Acad. Sci.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-05-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7506858     Medline TA:  Ann N Y Acad Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  115-22     Citation Subset:  IM    
Copyright Information:
© 2012 New York Academy of Sciences.
Affiliation:
University of Massachusetts Medical School, Worcester, Massachusetts.
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