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The article summarized in the section is Hypertension pharmacological treatment in adults: A World Health Organization guideline executive summary by Al-Makki et al., retrieved from Web. The article presents hypertension as a significant cause of cardiovascular disease and deaths globally, especially in middle and low-income countries. It provides new treatment guidelines for hypertension advanced by the World Health Organization Handbook for Guideline Development (Al-Makki et al., 2022). It presents research findings per the Grading of Recommendations, Assessment, Development, and Evaluations. The recommendations from the research are relevant to accurately diagnosing adults with lifestyle modification counseling.
There is a need to better lower blood pressure other than the usual safe, cost-effective, and well-tolerated therapies. Nonpregnant adults with hypertension should manage hypertension by initiating pharmacological therapy and BP treatment targets, utilizing healthcare workers, and creating intervals for follow-up visits (Al-Makki et al., 2022). The recommendations offer information for dual therapy, single-pill combinations, treatment algorithms, dual therapy, and monotherapy in managing hypertension. The balance between anticipated beneficial and undesirable effects, underlying evidence of cost-effectiveness and resource requirements, acceptability, health equity, treatment feasibility, and patient values and preferences dictate the guidelines.
Hypertension significantly influences the risk of all major cardiovascular events like peripheral vascular disease, sudden cardiac death, heart failure, and stroke. Significant breakthroughs in our understanding of its pathophysiology have helped highlight the disease’s complex origins involving the dysregulation of several homeostatic systems that influence blood pressure and the progression of end-organ damage associated with hypertension (Al-Makki et al., 2022). Growing evidence reveals that the pathophysiology of hypertension is caused by complicated interactions between environmental and genetic factors, resulting in varied illness risks and onset ages in the general population.
The first point to share from the article is its recommendation for combination therapy. Single-pill combination is recommended alongside therapy as initial treatment for adults with hypertension that require pharmacological treatment to improve persistence and adherence. Additionally, there are three classes from which to pick Antihypertensive medication; long-acting dihydropyridine calcium channel blockers, diuretics, and angiotensin-receptor blockers. However, one needs to conduct health economic analyses to quantify budget implications and the cost-effectiveness of implementing combination therapy instead of monotherapy.
Secondly, other risk factors for cardiovascular disease must be identified and treated correctly in all persons with hypertension to reduce total cardiovascular risk. In the lack of a calibrated equation for the local population, the choice should be based on the available resources and the acceptability and feasibility of the cardiovascular disease risk prediction tools (Al-Makki et al., 2022). However, in the incidence that assessing CVD risk may inhibit the timely beginning of hypertension medication, it should be delayed and incorporated as a follow-up measure.
Lastly, intensive treatment for selected patients complicates things for health workers. For example, emphasizing team-based care in low-resource situations necessitates straightforward and protocolized care (Al-Makki et al., 2022). Intensive therapy for some patients complicates treatment protocols and may result in decision overload, particularly for health providers with less expertise. However, despite being able to receive pharmacological treatment from nonphysician professionals like nurses and pharmacists, the WHO advises conditions like specific management protocols, proper training, and prescription authority (Al-Makki et al., 2022). Patients are more satisfied when they perceive their care comes from well-qualified as well as competent staff.
Adopting the guidelines has significant social implications because better treatment enhances hypertension control and helps lessen long-standing inequity. The guideline’s objective is to promote the adoption of a uniform strategy for the pharmacological management and treatment of hypertension, which will improve the global hypertension control rate. Managing blood pressure will lessen health disparities since preventing cardiovascular events lowers mortality rates.
Reference
Al-Makki, A., DiPette, D., Whelton, P. K., Murad, M. H., Mustafa, R. A., Acharya, S.,… & Khan, T. (2022). Hypertension pharmacological treatment in adults: A World Health Organization guideline executive summary. Hypertension, 79(1), 293-301. Web.
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