Hypertension treatment protocols PAHO countries

As of May 2019Based on information provided at PAHO Regional Workshop

CUBA

Tomado de: Perel P., Avezum A. Huffman M, País P., Rudgers A.,Vedanthan R., Wood D., Yussuf S. Reducing premature cardiovascular morbidity and mortality in people wit atherosteroclerotic vasculardisease. The World Heart Federation Roadmap for secondary prevention of Cardiovascular Disease. Global Heart, Vol. 10, No. 2 2015: 99-110

files.sld.cu/hta/files/2018/02/Guia-Cubana-de-Diagnóstico-Evaluación-y-Tratamiento-de-la-HTA/2017.pdf

COLOMBIA

Protocol from Chile

Protocolos

Algoritmo terapéuticoPANAMA

ARGENTINA

Algoritmo terapéutico - ECUADOR

https://almacenamiento.msp.gob.ec/index.php/s/6PMXDNE3wvrrx9v

Fármaco Dosis inicial

Dosis de intensificación

Frecuencia

Losartán 50mg - BIDAmlodipina 5mg 10mg QDClortalidona 12,5mg 25mg QD

SI TA ≥140 o ≥90 **

LOSARTÁN 50MG cada 12 horas +CLORTALIDONA 12,5MG al día

SI mantiene TA ≥140 o ≥90LOSARTÁN 50MG cada 12 horas +

CLORTALIDONA 25MG al día

SI mantiene TA ≥140 o ≥90LOSARTÁN 50MG cada 12 horas +

AMLODIPINO 5 mg al día + CLORTALIDONA 25MG al día

PASO 1

PASO 2

PASO 3

SI mantiene TA ≥140 o ≥90LOSARTÁN 50MG cada 12 horas +

AMLODIPINO10 mg al día + CLORTALIDONA 25MG al día

PASO 4

TAMIZAJE A TODOS LOS ADULTOS

CONTROL EN 1 MES

CONTROL EN 1 MES

CONTROL EN 1 MES

Hypertension Algorithm – TRINIDAD & TOBAGO

8

Step 1• ACE - Lisinopril 10mg, plus• CCB - Amlodipine 5mg

Step 2• ACE - Lisinopril 20mg, plus• CCB - Amlodipine 10mg

Step 3• ACE - Lisinopril 40mg, plus• CCB - Amlodipine 10mg

Step 4

• ACE - Lisinopril 40mg, plus• CCB - Amlodipine 10mg• Bendrofluazide 2.5 mg or Hydrochlorothiazide

12.5mg

Step 5• If Uncontrolled, REFER

Step 1• ARB - Irbesartan 150mg (Candesartan 16mg)* , plus• CCB - Amlodipine 5mg

Step 2• ARB - Irbesartan 300mg (Candesartan 32mg)*, plus• CCB - Amlodipine 10mg

Step 3

• ARB - Irbesartan 300mg (Candesartan 32mg)*, plus• CCB - Amlodipine 10mg• Add Chlorthalidone 12.5mg

Step 4• ARB - Irbesartan 300mg (Candesartan 32mg)*, plus• CCB - Amlodipine 10mg• Increase to Chlorthalidone 25 mg

Step 5• If Uncontrolled REFER

ALGORITHM 1 – ACCEPTABLEIf BP > 140/90 with No Comorbidities.If uncontrolled (sBP>140mmHg OR dBP>90mmHg) after one month, move to next step;

ALGORITHM 1 – PREFERREDIf BP > 140/90 with No Comorbidities.If uncontrolled (sBP>140mmHg OR dBP>90mmHg) after one month, move to next step;

* Candesartan may be substituted if Irbesartan unavailableAVOID ACE inhibitors and ARBs in Pregnancy