Management of hypertension in primary care

Abstract

Background: The European Society of Cardiology and the European Society of Hypertension define hypertension as systolic blood pressure ≥140 mmHg Hg, or diastolic blood pressure ≥90 mmHg Hg, or both. Hypertension is a challenging condition in view of it being asymptomatic, highly prevalent and requiring continuous follow-up by the family physician. Objective: To implement the available guidelines into clinical practice for better patient health.Method Multiple databases were used to perform the literature search including PubMed, National Institute of Clinical Excellence, Scottish Intercollegiate Guidelines Network, and the Turning Research Into Practice database. The following keywords were applied: hypertension, blood pressure, and primary care. Results: Blood pressure needs to be measured by a device which is regularly calibrated. This could be a traditional mercury sphygmomanometer, aneroid sphygmomanometer or the automated sphygmomanometer. The cuff size should be adjusted according to the patient’s arm circumference and the patient should be seated comfortably with the arm rested such that the cuff is at the same level as the heart. During the initial assessment, the blood pressure should be measured in both arms and then the arm with the highest reading is used for subsequent measurements. Ambulatory blood pressure monitoring should be offered if the blood pressure is found to be over 140/90mmHg (measured at least twice) during the initial assessment. Conclusion: Appropriate management of hypertension will contribute significantly towards an improvement in overall patient health.