Elevated blood pressure (also known as 'hypertension') is a common condition affecting nearly a quarter of Australians,1 and is the most frequently managed problem by general practitioners.2 Aside from its prevalence, elevated blood pressure is clinically important because it is major risk factor for complications from cardiovascular disease.3 As such, the direct costs of elevated blood pressure (e.g. anti-hypertensive medication prescription) are estimated as $812 million, with indirect costs totalling approximately $16.3 billion.4 Several countries, such as Canada,5 the United Kingdom,6 and USA7 have produced clinical practice guidelines (CPGs) to help guide the management of elevated blood pressure. Importantly, the Australian guideline has recently been updated.8, 9
Despite the availability of CPGs for the diagnosis and management of elevated blood pressure, a number of Australian studies report that usual care for the condition is often not evidence-based.4, 10, 11 In addition, our recent CareTrack Australia study demonstrated that, on average, people receive evidence-based care for elevated blood pressure 72% of the time – with particularly low compliance for people with severe elevated blood pressure.12 Therefore, the purpose of this wiki-based consultation process is to seek national agreement on what constitutes evidence-based and appropriate care for elevated blood pressure in Australia, and to organise this information within clinical indicators as a standard of care.
- Australian Bureau of Statistics 2016, National Health Survey. Available at: http://www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0.55.001. Accessed: 9th March 2017.
- Britt H, Miller GC, Henderson J, Bayram C, Harrison C, Valenti L, Pan Y, Charles J, Pollack AJ, Wong C, Gordon J. General practice activity in Australia 2015–16. General practice series no. 40. Sydney: Sydney University Press, 2016. Available at <purl.library.usyd.edu.au/sup/9781743325131>
- Bromfield, S. and Muntner, P., 2013. High blood pressure: the leading global burden of disease risk factor and the need for worldwide prevention programs. Current hypertension reports, 15(3), pp.134-136.
- Carrington M, Jain A, Stewart S: Pressure Points in Primary Care: A Study of Blood Pressure in 532,050 Patients in Australia from 2005 to 2010. Melbourne, Australia: Baker IDI Health and Diabetes Institute; 2012.
- Leung, A.A., Nerenberg, K., Daskalopoulou, S.S., McBrien, K., Zarnke, K.B., Dasgupta, K., Cloutier, L., Gelfer, M., Lamarre-Cliche, M., Milot, A. and Bolli, P., 2016. Hypertension Canada's 2016 Canadian Hypertension Education Program Guidelines for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Canadian Journal of Cardiology, 32(5), pp.569-588.
- National Institute for Health and Care Excellence, 2011. Hypertension in adults: diagnosis and Management. Available at: https://www.nice.org.uk/guidance/cg127/resources/hypertension-in-adults-diagnosis-and-management-35109454941637. Accessed: 9th March 2017.
- Weber, M.A., Schiffrin, E.L., White, W.B., Mann, S., Lindholm, L.H., Kenerson, J.G., Flack, J.M., Carter, B.L., Materson, B.J., Ram, C.V.S. and Cohen, D.L., 2014. Clinical practice guidelines for the management of hypertension in the community. The journal of clinical hypertension, 16(1), pp.14-26.
- National Heart Foundation of Australia. Guideline for the diagnosis and management of hypertension in adults – 2016. Melbourne: National Heart Foundation of Australia, 2016. Available at: https://www.heartfoundation.org.au/images/uploads/publications/PRO-167_Hypertension-guideline-2016_WEB.pdf. Accessed: 9th March 2017.
- Gabb, G.M., Mangoni, A.A., Anderson, C.S., Cowley, D., Dowden, J.S., Golledge, J., Hankey, G.J., Howes, F.S., Leckie, L., Perkovic, V. and Schlaich, M., 2016. Guideline for the diagnosis and management of hypertension in adults—2016. Med J Aust, 205(2), pp.85-89.
- Gallego, B., Runciman, W. B., Perez-Concha O., Liaw, S-T., Day, R. O., Dunn, A. G., Coiera, E., 2013. The management of severe hypertension in Australian general practice. BMC Health Services Research 2013, 13:414.
- Heeley E, Peiris D, Patel A, Cass A, Weekes A, Morgan C, Anderson C, Chalmers J: Cardiovascular risk perception and evidence-practice gaps in Australian general practice (the AusHEART study). MJA 2010, 195(5):254–259.
- Runciman, W.B., Hunt, T.D., Hannaford, N.A., Hibbert, P.D., Westbrook, J.I., Coiera, E.W., Day, R.O., Hindmarsh, D.M., McGlynn, E.A. and Braithwaite, J., 2012. CareTrack: assessing the appropriateness of health care delivery in Australia. Medical Journal of Australia, 197(10), p.549.