Comparison between the world health organization (WHO) and international society of hypertension (ISH) guidelines for hypertension

The global burden of hypertension remains an unsolved problem, especially in low- and middle-income countries (LMICs). For this reason, clinical practice guidelines containing the latest evidence-based recommendations are crucial in the management of hypertension. It is noteworthy that guidelines simply translated from those of high-income countries (HICs) are not the solution to the problem of hypertension in LMICs. Among the numerous guidelines available, those of the World Health Organisation and the International Society of Hypertension are the latest to be published as of the writing of this article. In this review, we conducted both general and specific comparisons between the recommendations supplied by both guidelines. Differences in aspects of hypertension management such as the timing of antihypertensive initiation, assessment of comorbidities and cardiovascular risk factors, pharmacological therapy selection, and blood pressure target and reassessment are explored. Lastly, the implications of the differences found between the two guidelines in both LMICs and HICs are discussed. Key messages Currently, with low treatment and control rates, hypertension remains a burden in low- and middle-income countries (LMICs). The lack of customised guidelines for LMICs cannot be solved simply by adopting guidelines from high-income countries. The World Health Organisation (WHO) recently published a clinical guideline for the pharmacological management of hypertension in LMICs. We compare select recommendations from the guidelines to those published by the International Society of Hypertension.

Automated summary

The burden of hypertension remains a significant problem worldwide, particularly in low- and middle-income countries. Clinical practice guidelines play a crucial role in managing hypertension, but simply adopting guidelines from high-income countries is not a solution for LMICs. This review compares the recommendations from the guidelines published by the World Health Organisation and the International Society of Hypertension and discusses the implications of the differences found between the two guidelines in both LMICs and high-income countries.