Key Messages : Clinical Practise Guideline on Hypertension, 2008

KEY MESSAGES: CLINICAL PRACTICE GUIDELINE
ON HYPERTENSION, 2008

1. Hypertension is defined as persistent elevation of systolic BP of 140
mmHg or greater and/or diastolic BP of 90 mmHg or greater.

2. The prevalence of hypertension in Malaysians aged 30 years and
above was 42.6% in 2006.

3. Hypertension is a silent disease; the majority of cases (64%) in the
country remain undiagnosed. Blood pressure should be measured
at every chance encounter.

4. Untreated or sub-optimally controlled hypertension leads to
increased cardiovascular, cerebrovascular and renal morbidity and
mortality.

5. A systolic BP of 120 to 139 and/or diastolic BP of 80 to 89 mmHg
is defined as prehypertension and should be treated in certain high
risk groups.  

6. Therapeutic lifestyle changes should be recommended for all
individuals with hypertension and prehypertension.

7. Decisions on pharmacological treatment should be based on global
vascular risks and not on the level of blood pressure per se.

8. In patients with newly diagnosed uncomplicated hypertension and
no compelling indications, choice of first line monotherapy includes
ACEIs, ARBs, CCBs and diuretics. Beta blockers are no longer
recommended for first line monotherapy in this group of patients.

9. Only 26% of Malaysian patients achieved blood pressure control
(<140/90 mmHg) while on treatment. Every effort should be made
to achieve target blood pressure. Target blood pressure depends
on specific patient groups.

10. Combination therapy is often required to achieve target and may
be instituted early.