Age-friendly Primary Health Care Centres Toolkit - World Health ...

AGE-FRIENDLY PRIMARY HEALTH CARE CENTRES TOOLKITII.4.2 Clinical assessment and key management approaches for two major chronicdiseasesManagement of hypertensionMost countries have national guidelines for classification of hypertension which should befollowed. If local guidelines are not available, please refer to the following guideline:INTIATION OF TREATMENT FOR HYPERTENSION IN OLDER PEOPLESBP >160mm HgOr DBP > 100 mm HgOn three separate occasions(Moderate/severe hypertension)SBP 140-159 mm HgOr DBP 90-99 mm Hgon several occasions(mild hypertension)Initiate Lifestyle measuresBegin drug treatmentInitiate Lifestyle measuresTarget organ damageNoAssess CVD(see table 1 page 68 )Assess other risk factors, targetorgan damage and associatedclinical conditions(see table1 page 68)YesCVD risk 20% or TargetOrgan Damage (TOD)CVD event risk accordingto WHO guidelines (seetable 2, page?) = veryhighReassess annuallyBegin drug treatmentSource: British Cardiac Society; British Hyperlipidaemia Association; British Hypertension Society; British Diabetic Association. JointBritish recommendations on prevention of coronary heart disease in clinical practice. Heart. 1998;80(suppl 2):S1–29, and World HealthOrganization, International Society of Hypertension Writing Group. 2003 World Health Organization (WHO)/International Society ofHypertension (ISH). Statement on management of hypertension. J Hypertens.2003;21:1983-199267