Asian management of hypertension: Current status,home blood pressure,and specific concerns in Vietnam

Hypertension and atherosclerotic diseases are becoming important public health issues in Vietnam. This is due, in part, to changing dietary patterns and lifestyles accompanying economic growth in the country. The most recent prevalence data suggest that 29% of the population has hypertension, and the rate of other cardiovascular risk factors is also high. Although use of home and ambulatory blood pressure monitoring (HBPM and ABPM) is increasing, Vietnamese physicians generally rely on office blood pressure (BP) for diagnosing and managing hypertension. A lack of availability and training are limiting factors. However, out‐of‐office BP monitoring is important to detect white‐coat and masked hypertension, and define the 24‐hour BP profile. This approach is recommended in current Vietnam Society of Hypertension and Vietnamese National Heart Association guidelines. Based on 2016 data, the most commonly used antihypertensive agents in Vietnam are angiotensin‐converting enzyme (ACE) inhibitors, followed by calcium channel blockers (CCBs) and diuretics, with ß‐blockers and angiotensin receptor blockers used less frequently. Combination therapy, usually with an ACE inhibitor plus CCB or diuretic, is quite common (used in 62% of patients). The participation of Vietnam in global hypertension initiatives and organizations has likely contributed to improved treatment and control rates over the last 10 years. Nevertheless, the prevalence of hypertension remains high and additional strategies are needed to reduce this and prevent cardiovascular disease.