ABSTRACT
DESCRIPTION: In January 2020, the U.S. Department of Veterans Affairs (VA) and the U.S. Department of Defense (DoD) approved a joint clinical practice guideline for the diagnosis and management of hypertension in the primary care setting. METHODS: The VA/DoD Evidence-Based Practice Work Group convened a joint VA/DoD guideline development effort that included a multidisciplinary panel of practicing clinician stakeholders and conformed to the Institute of Medicine's tenets for trustworthy clinical practice guidelines. The guideline panel developed key questions in collaboration with the ECRI Institute, which systematically searched and evaluated the literature from 15 December 2013 to 25 March 2019 and developed and rated recommendations by using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. RECOMMENDATIONS: This synopsis summarizes key features of the guideline in several key areas: the measurement of blood pressure, the definition of hypertension, target treatment goals, and nonpharmacologic and pharmacologic treatment of essential and resistant hypertension.
Subject(s)
Hypertension/diagnosis , Primary Health Care/standards , United States Department of Defense/standards , United States Department of Veterans Affairs/standards , Adult , Aged , Antihypertensive Agents/therapeutic use , Blood Pressure , Blood Pressure Determination/standards , Humans , Hypertension/drug therapy , Middle Aged , United StatesABSTRACT
This guideline represents an important step toward clarifying the evidence regarding the management of patients with hypertension within the VA/DoD primary care settings. As with other clinical practice guidelines, challenges remain, such as evidence gaps, the need to develop effective strategies for guideline implementation, and the need for strategies to evaluate the effect of guideline adherence on clinical outcomes. This guideline is primarily intended for health care practitioners in primary care, including physicians, nurse practitioners, physician assistants, pharmacists, nurses, and others involved in the care of patients with hypertension, although it may also be informative for specialty care practitioners.
