Good management is central to any strategy formulated to control hypertension at the community level. These guidelines are aimed at standardizing the management and care of hypertension, including control of blood pressure and complications in people with established hypertension and identification of individuals with high blood pressure who are at increased risk of complications; and at promoting integration of prevention of hypertension into primary health care settings, including lifestyle measures for prevention and management and cost-effectiveness. The guidelines are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as health and policy-makers. They provide the necessary information for decision-making by health care providers or patients themselves about disease management in the most commonly encountered situations.
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.
Hypertension remains a leading cause of disability and death worldwide. Self-monitoring of blood pressure by patients at home is currently recommended as a valuable tool for the diagnosis and management of hypertension. Unfortunately, in clinical practice, home blood pressure monitoring is often inadequately implemented, mostly due to the use of inaccurate devices and inappropriate methodologies. Thus, the potential of the method to improve the management of hypertension and cardiovascular disease prevention has not yet been exhausted. This volume presents the available evidence on home blood pressure monitoring, discusses its strengths and limitations, and presents strategies for its optimal implementation in clinical practice. Written by distinguished international experts, it offers a complete source of information and guide for practitioners and researchers dealing with the management of hypertension.
JNC and WHO-ISH management guidelines and results of key clinical trials are reviewed. Recommended approach for treatment is presented together with easy-to-follow treatment algorithms. Drug therapies are extensively discussed, with separate chapters dedicated to each class of antihypertensive medication. Treatment strategies for resistant hypertension are presented.
Diabetes and hypertension have evolved as two of the modern day epidemics affecting millions of people around the world. These two common co-morbidities lead to substantial increase in cardiovascular disease, the major cause of morbidity and mortality of adults around the world. In Diabetes and Hypertension: Evaluation and Management, a panel of renowned experts address a range of critical topics -- from basic concepts in evaluation and management of diabetes and hypertension, such as dietary interventions, to evaluation and management of secondary hypertension in clinical practice. Other chapters focus on high cardiovascular risk populations such as those with coronary heart disease, chronic kidney disease and minority patients. In addition, evolving concepts and new developments in the field are presented in other chapters, such as prevention of type 2 diabetes and the epidemic of sleep apnea and its implication for diabetes and hypertension evaluation and management. An important title covering two of the most troubling disorders of our time, Diabetes and Hypertension: Evaluation and Management will provide the busy practitioner with cutting edge knowledge in the field as well as practical information that can translate into better care provided to the high-risk population of diabetics and hypertensive patients.
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
The treatment of hypertension is now evolving into a decision-making process of ever greater complexity. Not only has the range of drugs available increased but so too has our knowledge of the diversity of individual patients' responsiveness to therapy, and the need to tailor their treatment with reference to a wide variety of additional factors. In order to provide effective patient care, the clinician needs to be aware of all the options available, but also of the evidence supporting their use and the extent to which that evidence justifies the choices made. In this new volume, leading authorities in their fields draw on the available evidence to provide answers to a series of key clinical questions facing the clinician treating hypertension: Should we treat prehypertension? How does the choice of therapy change in the presence of comorbidities such as obesity, ischemic heart disease, left ventricular hypertrophy, diabetes or cerebrovascular disease? Evidence-based Management of Hypertension provides answers to these and many other questions, as the authors present an expert analysis of the available evidence and offer authoritative recommendations for treatment planning. In each chapter, tables highlight evidence from a variety of sources, and every chapter concludes with a series of key practice points that present a summary of evidence-based recommendations for best practice, graded according to the quality of that evidence. For any clinician concerned with the care of the hypertensive patient, this volume will be a valuable aid to treatment planning and long-term management.
