Hypertension and lipid guideline updates

Hypertension and lipid guideline updates to commence in 2025 using a pioneering dynamic modular approach

The Heart Foundation is leading the development of two critical clinical guideline updates: one for managing hypertension (high blood pressure) and another for managing lipid levels (cholesterol). These new guidelines will be created using a pioneering dynamic modular approach, which will provide the most up-to-date, evidence-based recommendations to healthcare providers, ensuring people in Australia receive top-tier cardiovascular care.

Hypertension and abnormal lipid levels, both major contributors to cardiovascular disease and stroke, affect millions of people in Australia every year. By partnering with the Stroke Foundation, Hypertension Australia, the Australian Atherosclerosis Society, and leading clinical experts, these guidelines will aim to transform how hypertension and lipid disorders are managed.

The dynamic guideline development process

The fast pace of medical advancements in health and in particular cardiovascular health, means that traditional guideline development models are increasingly challenged in keeping up with the latest evidence. The Heart Foundation has spent some time exploring the pros and cons of a range of traditional approaches for clinical evidence synthesisation, and from this we have developed a new approach that draws on key requirements needed for a systematic evidence review, balanced with the need to keep pace with rapid evidence development.

We propose dynamic guideline development with a modular structure for cardiovascular guidelines, allowing for targeted, prioritised updates to specific sections (chapters) based on emerging evidence, rather than overhauling entire documents. We will employ the GRADE methodology to assess the quality of evidence and incorporate an adapt/adopt approach from traditional guidelines within our guideline development. Guidelines will be housed on a dynamic web-based platform allowing for streamlined and segmented updating as required. To ensure that no sections are neglected over time, we will implement scheduled comprehensive reviews of the entire guideline at predetermined intervals, reaffirming the relevance and accuracy of each section.

We see this as a practical and useful hybrid between a living guideline and a full traditional guideline development approach. Ultimately, dynamic guidelines could be integrated into clinical software, with guideline updates automatically incorporated into clinical practice. This approach ensures guidelines remain timely and relevant whilst optimising resources.

Unlike traditional models, the dynamic, modular framework allows for incremental updates rather than requiring complete guideline overhauls. Different clinical areas, such as diagnostic thresholds or treatment options, are prioritised based on new research, ensuring timely and relevant updates. As each module is completed, it will be released immediately, bypassing the traditionally long project timelines. This dynamic approach will enable ongoing improvements in patient care, reflecting the latest medical advancements.

This is a novel but practical approach that we believe will ensure that cardiovascular guidelines remain responsive to emerging evidence and continue to provide optimal outcomes for clinicians and patients alike.

Piloting the dynamic methodology for hypertension and lipid management

The 2025 Hypertension Guideline, closely followed by the Lipid Management Guideline will be the pilot projects for this dynamic methodology. This flexible, modular approach ensures faster integration of new research into clinical practice, making it easier for healthcare professionals benefit from continuous updates and evidence-driven recommendations.

Indicative timeline for the hypertension and lipid guideline updates

Implementation into clinical practice

New and more responsive ways to provide clinicians with up-to-date evidence-based guidelines is only one part of the equation. The Heart Foundation recognises the importance of translating and implementing evidence into clinical practice, and as a result, we have increased our focus on guideline implementation as a critical part of the work we do. In July 2024, we launched the new Australian Guideline for assessing and managing cardiovascular disease risk and the associated Aus CVD Risk Calculator. Following the launch of the new guideline and risk calculator, and with funding support from the Federal Department of Health and Aged Care, we have turned our attention to education and awareness for healthcare professionals and consumers to support implementation of the guideline. We are also undertaking key activities to integrate the Aus CVD Risk calculator into clinical practice software.

In early 2025, we will be launching the newly updated Acute Coronary Syndrome Guideline, which will be followed by a program of implementation. We are committed to implementing all guideline updates into clinical practice in a way that does not add to the burden of care for healthcare professionals.

Why this matters for Australian healthcare

The dynamic guidelines will revolutionise evidence-based care in Australia, providing clinicians with faster access to the latest evidence and treatment strategies. This approach will improve patient outcomes and streamline healthcare delivery, reducing the burden on both clinicians and the healthcare system.

For more information or updates on these dynamic guidelines, contact the Heart Foundation at [email protected].