What is the clinical evidence from this study?

Study design: Other. Population: Hypertensive adult patients in Thailand (n=5931). Intervention: Angiotensin receptor-neprilysin inhibitor (ARNI) vs. Placebo. Primary outcome: Change in office systolic and diastolic blood pressure compared to placebo (Office SBP reduced by 6.5 mmHg and DBP reduced by 3.3 mmHg versus placebo).

What does this research mean for the field?

The 2024 Thai guidelines introduce a new blood pressure category, 'BP at risk,' and recommend specific target blood pressure levels based on patient age for the treatment of hypertension. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To update evidence-based clinical recommendations for the diagnosis, evaluation, and management of adult hypertension suited to the healthcare context of Thailand.

February 21, 2026Asian BiomedicineOpen Access

2024 Thai guidelines on the treatment of hypertension

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Key result

ARNI reduces office SBP by 6.5 mmHg versus placebo in hypertensive patients.

Office SBP reduced by 6.5 mmHg and DBP reduced by 3.3 mmHg versus placebo
n=5,931

Why the study?

To update hypertension treatment guidelines incorporating new knowledge, real-life clinical practice, and evidence from worldwide clinical studies suitable for the context of Thailand.

Design

Clinical practice guidelines

Authors

SKSirisawat KunanonSiriraj Hospital PKPraew KotruchinKhon Kaen University PCP ChattranukulchaiKing Chulalongkorn Memorial Hospital

Discussion

Member takes

Implication

May support ARNI in updated hypertension guidelines; leaves open dedicated outcome trials.

Key Points

To update evidence-based clinical recommendations for the diagnosis, evaluation, and management of adult hypertension suited to the healthcare context of Thailand.
A clinical guideline committee synthesized global randomized trial evidence and local practice considerations to revise national hypertension standards for adults aged 18 years and older.
Recommendations were classified using defined recommendation strengths (Class I to III) and evidence quality levels (A to C), prioritizing high-quality clinical trial data.
The diagnostic office blood pressure threshold is maintained at 140/90 mmHg, while introducing a 'BP at risk' category of 130–139/80–89 mmHg and recommending out-of-office monitoring via HBPM or ABPM.
Blood pressure treatment targets are defined by age: 120–130/70–79 mmHg for patients aged 18–65 years and 130–139/70–79 mmHg for patients older than 65 years.
Initial treatment with a single-pill combination of two antihypertensive medications is recommended for most patients, selecting among five drug classes, while monotherapy is reserved for low-risk, frail elderly, or baseline 140–149/90–99 mmHg cases.

Structured PICO

Population

Adults aged 18 years and older with or at risk for hypertension in Thailand

Intervention

Guideline-directed diagnosis, lifestyle modification, and pharmacological treatment of hypertension

Main Result

Effect estimate: Office SBP reduced by 6.5 mmHg and DBP reduced by 3.3 mmHg versus placebo

The 2024 Thai guidelines provide updated recommendations for the diagnosis and management of hypertension, emphasizing out-of-office BP monitoring and early combination therapy.

Limitations

Lack of evidence demonstrating reduction in cardiovascular events with ARNI in hypertension patients
No data on long-term clinical outcomes in this population

Cite This Study

Kunanon et al. (2025) studied Hypertensive adult patients in Thailand (n=5,931). Angiotensin receptor-neprilysin inhibitor (ARNI) vs. Placebo was evaluated on Change in office systolic and diastolic blood pressure compared to placebo (Office SBP reduced by 6.5 mmHg and DBP reduced by 3.3 mmHg versus placebo). Angiotensin receptor-neprilysin inhibitor reduced office systolic blood pressure by 6.5 mmHg and diastolic blood pressure by 3.3 mmHg compared with placebo in hypertensive patients.

synapsesocial.com/papers/69994c38873532290d0208be https://doi.org/10.2478/abm-2025-0034

Topics

Hypertension management

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2024 Thai guidelines on the treatment of hypertension

Discussion

Member takes

Implication

Key Points

Structured PICO

Main Result

Limitations

Cite This Study

Topics

2024 Thai guidelines on the treatment of hypertension

Discussion

Member takes

Implication

Key Points

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider