Hypertension Guidelines: Timely New Initiatives from East Asia

摘要

This issue of Pulse brings together reviews of new or pending guidelines for the management of hypertension from China, Japan, Korea and Taiwan, covering the vast populations of East Asia [1-9]. This is a most timely and welcome initiative for many reasons. The first is that Asia is experiencing the 'second-wave epidemic', as it makes the transition from infectious diseases to chronic, non-communicable diseases, especially cardiovascular disease, overweight and diabetes. The second is that the burden of cardiovascular disease is quite different in Far East Asia, compared to western societies where stroke or cerebrovascular disease is much more common than coronary disease. Furthermore, there is a much higher incidence of haemorrhagic stroke in these nations, with a more direct and steeper relationship to high blood pressure, compared to western nations where ischaemic stroke predominates. The third reason is that the last few years have seen a break in the previous consensus amongst western guidelines, which had previously recommended a target blood pressure of < 140/90 mm Hg for most people with hypertension but <130/80 mm Hg for high-risk groups with previous vascular disease, diabetes or chronic kidney disease [10-12].