From the Guidelines
Patients with hypertension should start drug treatment immediately if they have Grade 2 hypertension (≥160/100mmHg) or if they are high-risk patients with Grade 1 hypertension (140-159/90-99mmHg) 1. When considering the ideal time to start treatment for hypertension, it's crucial to assess the severity of the condition and the patient's risk factors.
- For patients with Grade 2 hypertension, the evidence suggests that starting drug treatment immediately is the best course of action to reduce the risk of cardiovascular complications 1.
- For patients with Grade 1 hypertension, the approach depends on their risk profile. High-risk patients, such as those with cardiovascular disease, chronic kidney disease, diabetes, organ damage, or aged 50-80 years, should also start drug treatment immediately 1.
- For all other patients with persistent blood pressure elevation after 3-6 months of lifestyle intervention, starting drug treatment is recommended 1. The guidelines emphasize the importance of prompt treatment for high-risk patients and those with more severe hypertension to improve outcomes in terms of morbidity, mortality, and quality of life 1.
From the Research
Ideal Time to Start Treatment
The ideal time to start treatment varies depending on the disease and risk factors.
- For type 2 diabetes, preventive interventions should start as early as possible to allow for a wide variety of relatively low- and moderate-intensity programs 2.
- In the case of cardiovascular diseases, it is necessary to intervene in key risk factors early in life, as atherosclerosis is a long-term process that develops since childhood 3.
- For patients who have suffered a prior stroke or transient ischemic attack, immediate medical attention is crucial to minimize cerebrovascular damage and prevent recurrence 4.
- In patients with type 2 diabetes and high risk of or established cardiovascular disease, treatment guidelines recommend using an antihyperglycemic agent with proven cardiovascular benefit after metformin, regardless of glycated hemoglobin levels 5.
Importance of Early Intervention
Early intervention is crucial in preventing or delaying the onset of diseases.
- Sustainability within a type 2 diabetes prevention program is more important than the actual point in time or disease process at which prevention activities may start 2.
- Early pharmacological intervention has a clear effect on slowing or stopping the process of atherosclerosis 3.
- Rapid treatment following a stroke or transient ischemic attack can minimize cerebrovascular damage and prevent recurrence 4.
- Selecting medication for patients with type 2 diabetes should focus on reducing the risk of cardiovascular disease, and early intervention can help achieve this goal 5.