Abstract:
Background
The regional epidemic of hypertension in Southeast Asia indicates an important role for clinical practice guidelines (CPGs) to optimize its management. This study aimed to evaluate the methodological quality and the rate of concordance of recommendations across the CPGs in Southeast Asia with internationally reputable CPGs.
Methods
CPGs for the management of hypertension in Southeast Asia were retrieved from the websites of Ministry of Health or cardiovascular specialty societies of the individual countries during November to December 2020. Two reviewers independently appraised the methodological quality of all the included CPGs using the Appraisal of
Guideline ResEarch and Evaluation instrument. The recommendations for the
management of hypertension specified in the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline and the 2018 European Society of Cardiology (ESC)/European Society of Hypertension (ESH) guideline were selected to be the reference standards; the recommendations concerning the management of hypertension in the included CPGs in Southeast Asia were assessed if
they were concordant with the reference recommendations.
Results
We identified six CPGs for the management of hypertension in Southeast Asia. Upon quality appraisal, except for the CPG originated from Malaysia which could be “recommended” for use in practice, the remaining five CPGs could only be “weakly recommended”. Considering the six included CPGs from Southeast Asia, concordance was observed for 30 out of 59 (50.8%) reference recommendations generated from the
2017 ACC/AHA guideline and for 31 out of 51 (69.8%) reference recommendations derived from the 2018 ESC/ESH guideline.
Conclusion
More efforts should be invested to improve the methodological quality of the CPGs for the management of hypertension in Southeast Asia. While the CPGs in Southeast Asia have a high rate of non-concordance with internationally reputable CPGs, the concordant recommendations could perhaps be considered a standard of care for the regional management of hypertension in Southeast Asia.
Keywords: AGREE II; CPG; Guideline; Hypertension; Recommendation
