2019 Thai Guidelines on the Treatment of Hypertension:
Executive Summary
Sirisawat Kunanon MD¹, Pairoj Chattranukulchai MD², Chavalit Chotruangnapa MD¹, Weerapat Kositanurit MD³,
Komsing Methavigul MD⁴, Thananya Boonyasirinant MD⁵, Petch Rawdaree MD⁶, Sirakarn Tejavanija MD⁷,
Tuangsit Wataganara MD⁸, Bancha Satirapoj MD⁹, Weranuj Roubsanthisuk MD¹, Nijasri C Suwanwela MD¹⁰,
Somkiat Sangwatanaroj MD², Rapeephon Kunjara Na Ayudhya MD¹¹, Surapun Sitthisook MD²,
Apichard Sukonthasarn MD¹²
Affiliation : ¹ Division of Hypertension, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand ² Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand ³ Department of Physiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ⁴ Department of Cardiology, Central Chest Institute of Thailand, Nonthaburi, Thailand ⁵ Division of Cardiology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand ⁶ Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand ⁷ Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand ⁸ Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand ⁹ Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand ¹⁰ Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ¹¹ Department of Cardiology, Vichaiyut Hospital and Medical Center, Bangkok, Thailand ¹² Thai Hypertension Society, Bangkok, Thailand
The revision committee of the 2019 Thai Guidelines on the Treatment of Hypertension has reviewed new developments in the body of knowledge,
together with the expertise in real-life clinical practice and evidence collected from clinical studies worldwide. The guidelines consist of newly
highlighted key topics to ensure the guidelines remain up to date, user friendly, and suitable for the country’s context. The guidelines still maintain
the current office blood pressure (BP) cut-off point of 140/90 mmHg for the diagnosis of hypertension. The use of out-of-office BP measurements,
including home BP monitoring (HBPM) or ambulatory BP monitoring (ABPM), is also advocated to confirm the diagnosis of hypertension. Target
BP levels depend on the age of the patients, such as 120 to 130/70 to 79 mmHg for patients aged 18 to 65 years old, or 130 to 139/70 to 79 mmHg
for patients over 65 years of age. There are five main groups of antihypertensive medication, angiotensin-converting enzyme inhibitors, angiotensin
receptor blockers, beta-blockers, calcium-channel blockers, and thiazides or thiazide-like diuretics. Two types of medications should be started for
most patients, except for frail elderly patients, patients with a relatively low initial BP of 140 to 149/90 to 99 mmHg, and low-risk patients, in which
only one type of starting medication should be selected. Medication that involves a combination of two types in one pill should ideally be selected.
Received 25 May 2021 | Revised 7 July 2021 | Accepted 12 July 2021
doi.org/10.35755/jmedassocthai.2021.10.12199
Keywords :
Hypertension; Guidelines; Thailand
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