Director-General Dr Brundtland's reply to the letter about the 1999 WHO/ISH Hypertension Guidelines

Director-General Dr Brundtland's reply to the letter about the 1999 WHO/ISH Guidelines for the Management of Hypertension

WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTE

Dear Dr Sandvik,
4 May 1999

1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension
Thank you for your letter dated 16 March 1999 concerning the 1999 Guidelines for the Management of Hypertension. I have also seen other correspondence on this subject on the Internet. The concerns expressed in your letter about the "goals of treatment" and the debate these guidelines have generated are appreciated.
The recommendations contained in the 1999 Guidelines were prepared by a WHO/ISH Working Group in 1997 and 1998. They were developed by eminent international experts using the latest information from epidemiological studies and randomised controlled trials. The guidelines emphasize that a decision to lower elevated blood pressure in a particular individual is not based on the level of blood pressure alone, but on assessment of the total cardiovascular risk.
Needless to say, cost-effectiveness, availability, accessibility, and affordability of drugs, which were not addressed in the guidelines, need to be taken into consideration when countries develop their own policies. In this respect, the new guidelines may be used to provide the basis for such policies and should be modified to suit local circumstances influencing the management of hypertension in a given country.
I should also like to indicate at this stage that the newly-established Noncommunicable Disease Cluster is currently developing new principles and methodologies for the elaboration of future guidelines. These principles will address, in addition to a strong emphasis on the evidence base of recommendations, consideration of cost-effectiveness and other factors related to the public health impact of the guidelines. Therefore, the current WHO/ISH recommendations will be subject to broad review which WHO will conduct in close consultation and coordination with the International Society of Hypertension in line with the new methodologies for guideline development.
As to the concerns you express about the role of the private industry and its potential influence, there should be no conflict of interest in our partnership with private industry. This subject will be closely monitored by the Committee on Private Sector collaboration which I established in recent months.
Yours sincerely,
Gro Harlem Brundtland, MD, MPH
Director-General

Back to the letter

Updated May 6, 1999
Hogne.Sandvik@isf.uib.no

WORLD HEALTH ORGANIZATION		ORGANISATION MONDIALE DE LA SANTE


Dear Dr Sandvik,		4 May 1999

1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension Thank you for your letter dated 16 March 1999 concerning the 1999 Guidelines for the Management of Hypertension. I have also seen other correspondence on this subject on the Internet. The concerns expressed in your letter about the "goals of treatment" and the debate these guidelines have generated are appreciated. The recommendations contained in the 1999 Guidelines were prepared by a WHO/ISH Working Group in 1997 and 1998. They were developed by eminent international experts using the latest information from epidemiological studies and randomised controlled trials. The guidelines emphasize that a decision to lower elevated blood pressure in a particular individual is not based on the level of blood pressure alone, but on assessment of the total cardiovascular risk. Needless to say, cost-effectiveness, availability, accessibility, and affordability of drugs, which were not addressed in the guidelines, need to be taken into consideration when countries develop their own policies. In this respect, the new guidelines may be used to provide the basis for such policies and should be modified to suit local circumstances influencing the management of hypertension in a given country. I should also like to indicate at this stage that the newly-established Noncommunicable Disease Cluster is currently developing new principles and methodologies for the elaboration of future guidelines. These principles will address, in addition to a strong emphasis on the evidence base of recommendations, consideration of cost-effectiveness and other factors related to the public health impact of the guidelines. Therefore, the current WHO/ISH recommendations will be subject to broad review which WHO will conduct in close consultation and coordination with the International Society of Hypertension in line with the new methodologies for guideline development. As to the concerns you express about the role of the private industry and its potential influence, there should be no conflict of interest in our partnership with private industry. This subject will be closely monitored by the Committee on Private Sector collaboration which I established in recent months. Yours sincerely, Gro Harlem Brundtland, MD, MPH Director-General Back to the letter Updated May 6, 1999 Hogne.Sandvik@isf.uib.no