3. RECOMMENDATION ON CARDIOVASCULAR DISEASE RISK ASSESSMENT
WHO suggests cardiovascular risk assessment at or after the initiation of pharmacological treatment for hypertension, but only where this is feasible and does not delay treatment.
Conditional recommendation, low-certainty evidence
Implementation remarks:
  • Most patients with SBP ≥140 or DBP ≥90 mmHg are high risk and indicated for pharmacological treatment; they do not require cardiovascular (CVD) risk assessment prior to initiating treatment. CVD risk assessment is most important for guiding decisions about initiating pharmacological treatment for hypertension (HTN) in those with lower SBP (130–139 mmHg). It is critical in those with HTN that other risk factors must be identified and treated appropriately to lower total cardiovascular risk.
  • Many CVD risk-assessment systems are available. In the absence of a calibrated equation for the local population, the choice should depend on resources available, acceptability and feasibility of application.
  • Whenever risk assessment may threaten timely initiation of HTN treatment and/or patient follow up, it should be postponed and included in the follow-up strategy, rather than taken as a first step to indicate treatment.

From: 3, Recommendations

Cover of Guideline for the pharmacological treatment of hypertension in adults
Guideline for the pharmacological treatment of hypertension in adults [Internet].
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