On December 20, 2019, the Ministry of Health issued Decision No. 5904/QĐ-BYT. This decision promulgated documents on non-communicable diseases at Commune Health Stations. This is an important legal document to control hypertension. Below are the core points in professional work at the commune level.

1. Definitive diagnosis criteria

At the grassroots health level, diagnosis is based on readings measured at the clinic.

Definition: Hypertension is when Systolic Blood Pressure ≥ 140 mmHg and/or Diastolic Blood Pressure ≥ 90 mmHg.

Measurement procedure: Medical staff need to measure blood pressure according to the correct procedure. Definitive diagnosis is made when measured at least at 02 different examination visits. Each measurement is performed at least 02 times, and the average value is taken.

Note: If blood pressure is ≥ 180/110 mmHg accompanied by acute signs, immediate emergency handling is needed. Timely referral is mandatory when there is target organ damage.

2. Treatment principles at Commune Health Stations

The goal is to achieve a blood pressure level below 140/90 mmHg. Simultaneously, doctors need to maximize the reduction of long-term cardiovascular risk.

Continuous and long-term treatment: Hypertension is a chronic disease. Patients need to be monitored for life. They must not arbitrarily stop medication when blood pressure has returned to normal.

Combining measures: Treatment must combine lifestyle changes and medication use.

Individualization: The protocol needs to be suitable for each patient. This is based on blood pressure readings and accompanying pathologies.

3. Instructions on lifestyle changes (Non-drug treatment)

This is a mandatory foundation for every patient.

Diet: Patients need to reduce salt intake to under 5g per day. Increase green vegetables, fresh fruits, and limit animal fat.

Physical activity: Exercise regularly for at least 30 minutes per day. Maintain training for at least 5 days per week.

Habits: Patients need to stop smoking cigarettes and pipe tobacco. Limit alcohol and beer and avoid anxiety and stress. Need to avoid a sudden cold.

Weight control: Maintain BMI from 18.5 to 22.9. Perform weight loss if the patient is overweight or obese.

4. Patient management and monitoring

The central task is the outpatient management of hypertensive patients.

Establishing management records: Every patient needs to have a chronic medical record established.

Periodic re-examination: Patients re-examine at least once/month. The Health Station will dispense medicine and evaluate treatment effectiveness.

Referral: Need to transfer to a higher level when suspecting secondary hypertension. Or when hypertension is resistant despite using a combination of 3 types of drugs. Refer when there are serious cardiovascular, eye, or kidney complications. Pregnant women with hypertension also need to be referred promptly.

The article references information from Decision 5904/QĐ-BYT of the Ministry of Health.

Assoc. Prof. Dr. La Ngoc Quang – Center for Support & Continuing Education