The National Center for Cardiovascular Diseases, the Chinese Medical Doctor Association (CMDA), and other organizations have released the revised “Clinical Practice Guidelines for Hypertension in China.” The updated guidelines adjust the diagnostic criteria for hypertension and provide detailed evidence-based recommendations for treating the disease, including both primary and secondary hypertension.
Diagnostic Criteria and Patient Classification
The new guidelines recommend lowering the diagnostic threshold for adult hypertension in China from systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg to SBP ≥ 130 mmHg and/or DBP ≥ 80 mmHg. Adult hypertensive patients are divided into two grades based on blood pressure levels: Grade 1 (SBP 130-139 mmHg and/or DBP 80-89 mmHg) and Grade 2 (SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg). The guidelines note that under the same treatment mode, higher pre-treatment levels of SBP or DBP correlate with a greater range of blood pressure reduction and a higher reduction in cardiovascular event risk. Therefore, the blood pressure classification of patients with SBP/DBP ≥ 140/90 mmHg before treatment may not be considered when determining the type, dose, or combination of antihypertensive drugs and other treatment strategies. This grading method simplifies the cardiovascular disease risk stratification for patients.
Treatment Recommendations
The guidelines recommend that patients classified as high-risk based on cardiovascular risk stratification should immediately start antihypertensive drug treatment. This includes patients with Grade 1 hypertension who have clinical complications, target organ damage, or more than three cardiovascular risk factors, as well as all patients with Grade 2 hypertension. For patients with hypertension complicated by atrial fibrillation, coronary heart disease, heart failure, diabetes, or stroke with stable conditions, and patients without clinical complications aged under 65 years, the guidelines recommend a target blood pressure control value of SBP/DBP < 130/80 mmHg.
The guidelines also highlight that, based on international standards, 22.7% of Chinese adults aged 35 and above with Grade 1 hypertension need antihypertensive drug treatment, amounting to an estimated 39.9 million people. According to the latest drug prices and medical insurance system in China, it is cost-effective for this population to take antihypertensive drugs over the next 10 years or even for life, even if they are free of cardiovascular disease.
Non-Pharmacological Interventions
In addition to pharmacological treatment, the guidelines recommend that Chinese patients with hypertension actively engage in non-drug interventions, conduct home blood pressure monitoring, and enhance self-management of hypertension.-Fineline Info & Tech
