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

AGE-FRIENDLY PRIMARY HEALTH CARE CENTRES TOOLKITdiabetesPresence of VERY HIGH RISK VERY HIGH RISK VERY HIGH RISKassociatedclinicalconditions*Risk category refers to the risk of a cardiovascular event within 10 years: low risk: 30%Source: British Cardiac Society; British Hyperlipidaemia Association; British Hypertension Society; BritishDiabetic Association. Joint British recommendations on prevention of coronary heart disease in clinical practice.Heart. 1998;80(suppl 2):S1–29, and World Health Organization, International Society of Hypertension WritingGroup. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH). Statement onmanagement of hypertension. J Hypertens.2003;21:1983-1992Guidelines for management of hypertensionAssessment A full assessment of cardiovascular risks should be carried out for all hypertensivepatients Blood pressure measurement is critical to the management of hypertension.Validated equipment should be used and national guidelines or the guidelines aboveshould be followed. The normal range for home blood pressure measurements and ambulatory bloodpressure monitoring is lower than “normal” surgery or clinic values. Accelerated phase (malignant) hypertension requires urgent hospital admission forinvestigation and treatment.Thresholds and targets for treating hypertension in older people Both systolic and diastolic hypertension require treatment. Thresholds for antihypertensive therapy and targets for treatment should be set andshould take into account both the level of blood pressure and other risk factors. The decision to start treatment should be based on a structured assessment ofcardiovascular risk. A target blood pressure of