Hypertension incurs a significant healthcare burden in Asia-Pacific countries, which have suboptimal rates of blood pressure (BP) treatment and control. A consensus meeting of hypertension experts from the Asia-Pacific region convened in Hanoi, Vietnam, in April 2013. The principal objectives were to discuss the growing problem of hypertension in the Asia-Pacific region, and to develop consensus recommendations to promote standards of care across the region. A particular focus was recommendations for combination therapy, since it is known that most patients with hypertension will require two or more antihypertensive drugs to achieve BP control, and also that combinations of drugs with complementary mechanisms of action achieve BP targets more effectively than monotherapy. The expert panel reviewed guidelines for hypertension management from the USA and Europe, as well as individual Asia-Pacific countries, and devised a treatment matrix/guide, in which they propose the preferred combination therapy regimens for patients with hypertension, both with and without compelling indications. This report summarizes key recommendations from the group, including recommended antihypertensive combinations for specific patient populations. These strategies generally entail initiating therapy with free drug combinations, starting with the lowest available dosage, followed by treatment with single-pill combinations once the BP target has been achieved. A single reference for the whole Asia-Pacific region may contribute to increased consistency of treatment and greater proportions of patients achieving BP control, and hence reducing hypertension-related morbidity and mortality.
Prediabetes and diabetes burden become the strong challenge in the Western Pacific region. Prediabetes with impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and the mixed status (IFG + IGT) are considered as risk factors for the development of diabetes. Effective early intervention for prediabetes can significantly delay the progression of the onset of diabetes, even if reverse blood glucose to normal. Increasing evidence shows that without targeted intervention, the progression from prediabetes to diabetes occurs more frequently in Asians compared with Caucasians. Consequently, it is essential to timely detect the populations at higher risk and effectively implement intervention and management to prevent diabetes. Significant evidence also supports the effectiveness of adjusting lifestyle in combination with medication to delay the onset of diabetes. A working group of Western Pacific expertise in diabetes conducted to develop evidence-based consensus recommendations to guide the management of patients with prediabetes. These consensual recommendations are intended to provide a clear and concise approach to the management of individuals with prediabetes.