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2015 Guidelines of the Taiwan Society of Cardiology and the Taiwan Hypertension Society for the Management of Hypertension  Chern-En Chiang, Tzung-Dau.

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Presentation on theme: "2015 Guidelines of the Taiwan Society of Cardiology and the Taiwan Hypertension Society for the Management of Hypertension  Chern-En Chiang, Tzung-Dau."— Presentation transcript:

1 2015 Guidelines of the Taiwan Society of Cardiology and the Taiwan Hypertension Society for the Management of Hypertension  Chern-En Chiang, Tzung-Dau Wang, Kwo-Chang Ueng, Tsung-Hsien Lin, Hung-I Yeh, Chung-Yin Chen, Yih-Jer Wu, Wei-Chuan Tsai, Ting-Hsing Chao, Chen-Huan Chen, Pao-Hsien Chu, Chia-Lun Chao, Ping-Yen Liu, Shih-Hsien Sung, Hao-Min Cheng, Kang-Ling Wang, Yi-Heng Li, Fu-Tien Chiang, Jyh-Hong Chen, Wen-Jone Chen, San-Jou Yeh, Shing-Jong Lin  Journal of the Chinese Medical Association  Volume 78, Issue 1, Pages 1-47 (January 2015) DOI: /j.jcma Copyright © Terms and Conditions

2 Fig. 1 Diagnosis algorithm. This algorithm does not apply to very elderly patients (age ≥80 years) because their treatment threshold and targets are 150/90 mmHg. For special patient groups (coronary heart disease, diabetes, or proteinuric chronic kidney disease), lower BPs are applied (* ≥130/80 mmHg; # 120–129/70–79 mmHg; § <120/70 mmHg). ABPM = ambulatory blood pressure monitoring; BP = blood pressure; FU = follow-up; HBPM = home blood pressure monitoring; LSM = life style modification; m = month; TOD = target organ damage (including left ventricular hypertrophy by electrocardiogram, microalbuminuria, or asymptomatic atherosclerosis [carotid intima-media thickening or aortic plaque], ankle-brachial index<0.9, or increased pulse wave velocity); y = year. (Modified from Chiang et al.9 with permission.) Journal of the Chinese Medical Association  , 1-47DOI: ( /j.jcma ) Copyright © Terms and Conditions

3 Fig. 2 Treatment algorithm. This algorithm is not applicable in very elderly patients (age ≥80 years). CHD = coronary heart disease; CKD = chronic kidney disease; DM = diabetes mellitus; SPC = single-pill combination. (Modified from Chiang et al.9 with permission.) Journal of the Chinese Medical Association  , 1-47DOI: ( /j.jcma ) Copyright © Terms and Conditions

4 Fig. 3 Rule of 10. Panel A. Comparison of effects of incremental doses of 5 classes of anti-hypertension drugs on reducing systolic blood pressure (SBP) at a baseline SBP of 154 mmHg. On average, there is a 10-mmHg decrease in SBP by a standard dose of any kind of the 5 classes of drugs (Rule of 10). Doubling the dose of any drug brings out only a 2-mmHg incremental decrease in SBP. Panel B. Combination of drugs from different classes is more effective in reducing SBP than increasing doses of the same drug. The combination of 2 drugs from different classes decreases SBP by 20 mmHg (10 + 10 = 20); whereas doubling doses decreased SBP further by 2 mmHg only (10 + 2 = 12). To decrease SBP by 30 mmHg, 3 drugs of different classes are generally needed. Data were modified from article by Laws et al.245 Journal of the Chinese Medical Association  , 1-47DOI: ( /j.jcma ) Copyright © Terms and Conditions

5 Fig. 4 Rule of 5. Panel A. Comparison of the effects of incremental doses of 5 classes of anti-hypertension drugs on reducing diastolic blood pressure (DBP) at a baseline DBP of 97 mmHg. On average, there is a 5-mmHg decrease in DBP by a standard dose of any kind of the 5 classes of drugs (Rule of 5). Doubling the dose of any drug brings out only a 1-mmHg incremental decrease in DBP. Panel B. Combination of drugs from different classes is more effective in reducing DBP than increasing doses of the same drug. The combination of 2 drugs from different classes decreases DBP by 10 mmHg (5 + 5 = 10); whereas doubling doses decreased DBP further by 1 mmHg only (5 + 1 = 6). To decrease DBP by 15 mmHg, 3 drugs of different classes are generally needed. Data were modified from article by Laws et al.245 Journal of the Chinese Medical Association  , 1-47DOI: ( /j.jcma ) Copyright © Terms and Conditions

6 Fig. 5 Adjustment algorithm. BP = blood pressure.
Journal of the Chinese Medical Association  , 1-47DOI: ( /j.jcma ) Copyright © Terms and Conditions


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