Guideline for the pharmacological treatment of hypertension in adults: web annex A: summary of evidence

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World Health Organization

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185 p.
This Web Annex accompanies the WHO Guideline for the pharmacological treatment of hypertension in adults and provides the evidence base underpinning the guideline recommendations. Prepared in accordance with the WHO handbook for guideline development, it presents the systematic reviews, GRADE evidence profiles and evidence-to-decision frameworks used by the guideline development group to assess the benefits, harms and certainty of the available evidence for pharmacological management of hypertension in adults. The annex is organized around 11 PICO questions addressing key aspects of hypertension treatment, including thresholds for initiating pharmacological therapy, the role of laboratory testing and cardiovascular risk assessment, selection of first-line antihypertensive agents, monotherapy versus combination therapy, use of single-pill combinations, blood pressure treatment targets, follow-up intervals after treatment initiation, and delivery of pharmacological management by nonphysician care providers. Evidence summaries evaluate clinical outcomes such as mortality, cardiovascular events, stroke, myocardial infarction, heart failure, kidney disease, adverse effects and treatment discontinuation across different populations and clinical settings. The publication provides the methodological foundation supporting the guideline recommendations and promotes transparency in the evidence appraisal process.

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