Executive Summary of the 2024 Philippine Clinical Practice Guidelines on the Diagnosis and Management of Acute Severe Blood Pressure Elevation

A recent survey in the Philippines, PRESYON-4, showed increasing prevalence of hypertension from 22% in the 1990s to 37% in 2021, of which only 52% were aware of their diagnosis. While rates of treatment and adherence were 68% and 86%, respectively, the rate of BP control was low at 37%. Furthermore, there remained a high degree of unawareness regarding hypertension, its role in CV morbidity and mortality, and how it can be optimally managed. In particular, there is a knowledge gap in the diagnostic approach and management of severe acute elevations in blood pressure. In response to this, the Philippine Society of Hypertension, Philippine Heart Association, and multiple experts from various sectors worked together to develop the 2024 Clinical Practice Guideline on the Diagnosis and Management of Severe Blood Pressure Elevation. The CPG provides eleven (11) recommendations and four (4) best practice statements addressing key clinical questions on the diagnosis and management of severe BP elevation. The guideline development process adhered to the GRADE approach through the Evidence to Decision (EtD2) framework, including the identification of critical questions and outcomes, retrieval of current evidence, appraisal and synthesis of the evidence, and formulation of draft recommendations. A multisectoral consensus panel (CP) was convened to discuss values, preferences, and socioeconomic impact and finalize the strength of the recommendations. The CPG is intended to be used by general practitioners, specialists, family physicians, allied health professionals, emergency medical personnel, and healthcare workers who may encounter adult patients with hypertension, whether in the inpatient or outpatient setting.