2020 Clinical Practice Guidelines for Hypertension in the Philippines PDF
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2020
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Summary
This document summarizes clinical practice guidelines for the management of hypertension in the Philippines in 2020. It details target blood pressures for various patient conditions and discusses preferred medication choices. The guidelines aim to inform medical professionals about best practice in hypertension management.
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Summary of 2020 Clinical Practice Guidelines for the Management of Hypertension in the Philippines Condition BP threshold for initiating Blood Pressure Targets Preferred Agents pharmacotherapy General Most adult 140/9...
Summary of 2020 Clinical Practice Guidelines for the Management of Hypertension in the Philippines Condition BP threshold for initiating Blood Pressure Targets Preferred Agents pharmacotherapy General Most adult 140/90 mmHg Most adults less than 1. Angiotensin-converting 140/90 mmHg enzyme inhibitors 80 years old and above 2. Angiotensin-receptor 150/90 mmHg 80 years old and above Blockers less than 140/90 mmHg 3. Calcium Channel Blockers 4. Thiazide Diuretics Diabetes Mellitus >/= 140/90 mmHg CV risk reduction: < Low-dose combination of 140/90 mmHg ACE-I OR ARB with CCB or thiazide diuretic additional benefit for strole reduction and decreased risk for nephropathy: < 130/80 mmHg Chronic Kidney Disease >/= 140/90 mmHg For low risk of CV disease 1. Angiotensin-converting and CKD IV and V: < enzyme inhibitors 140/90 2. Angiotensin-receptor Blockers For CKD III: < 130/80 3. Dihydropyridine Calcium mmHg Channel Blockers 4. Thiazide Diuretics For non-dialysis patients: SBP < 120 mmHg CKD with albuminuria/proteinuria Patients with urine (urinary Albumin to creatine excretion of more than ratio more than or equal to 30 30mg per 24 hours: < mg/g: ACE inhibitor 130/80 mmHg *discontinue if creatine levels rise above 30% over baseline during the first two months of treatment or if with hyperkalemia *may shift to non- dihydropyridine calcium channel blockers Resistant Hypertension: may add Mineralocorticoid Receptor Antagonist Acute Ischemic Stroke > 185/110 mmHg < 185/110 mmHg prior to Nicardipine eligible for IV thrombolysis thrombolysis and during but not for mechanical infusion Labetalol thrombectomy < 180/105 mmHg in the next 24 hours Acute Ischemic Stroke not Severe Hypertension: If with sever hypertension, Nicardipine eligible for IV thrombolysis SBP > 220 mmHg reduce the BP by 15% or mechanical DBP > 120 mmHg during the first 24 hours thrombectomy after the onset of stroke Intracranial Hemorrhage SBP >/= 180 mmHg < 180 mmHg Nicardipine Careful SBP lowering, avoiding reductions >/= 60 Labetalol mmHg in 1 hour Do not lower the BP acutely to < 140 mmHg Secondary Prevention of 140/90 mmHg /= 140/90 mmHg /= 160 *Oral extended release mmHg OR DBP >/= 110 Nifedipine mmHg OR Both OPD options: 1. Methyldopa 2. Calcium Channel Blockers 3. Beta-blockers Pediatric Population Reduction in SBP and 1. ACE inhibitors (Enalapril, DBP to
