Uganda guidelines for the treatment of Hypertension
Uganda Clinical Guidelines 2023 · all from source →
General Adult
Diagnosis
Classification
Normal: <120/80. Pre-hypertension: 120-139/80-89. Stage 1: 140-159/90-99. Stage 2: >160/>100.
Clinical Features
Majority are symptomless. General symptoms: Headache, palpitations, dizziness. Complications: stroke, heart failure, renal failure, visual impairment.
Investigations
Urine analysis, blood sugar, U&Es, Chest X-ray, ECG.
Treatment
Stage 1 (Step 1)
Lifestyle adjustments (reduce salt, increase exercise, reduce weight, stop smoking/alcohol). If fails within 3 months, start meds.
Stage 1 (Step 2)
Amlodipine 5 mg once daily. If uncontrolled after 1 month, move to Stage 2.
Stage 2 (Step 3)
Amlodipine 5 mg once daily PLUS Angiotensin II receptor blocker (ARB) e.g. Losartan 50mg (or Valsartan 80mg or Telmisartan 40mg) once daily. (Alternatively ACEI like Lisinopril 20mg or Enalapril 5mg).
Stage 2 (Step 4)
If BP ≥140/90 after 1 month: Increase Amlodipine to 10 mg once daily PLUS Losartan 50mg.
Stage 2 (Step 5)
If BP ≥140/90 after 1 month: Amlodipine 10 mg PLUS Losartan 100mg PLUS Thiazide diuretic (e.g. Hydrochlorothiazide 12.5mg once in the morning).
Special Populations
Pregnancy: DO NOT use ACEI, ARBs, or diuretics. Methyldopa and CCBs are safe. CKD: initial therapy ACEI/ARB + CCB or diuretic.
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