The impact of the esc 2024 hypertension guidelines on a population sample with a mean age of 59.56 years: a comparative analysis

Background/Introduction Hypertension is the most prevalent cardiovascular disease (CVD) at the global level. According to the World Health Organization, two-thirds of people with hypertension live in low-income and middle-income countries. The global age-standardized average prevalence of hypertension in adults aged 30– 79 years was reported to be 34% in men and 32% in women. Despite the existence of proven effective strategies for the treatment, blood pressure control rates remain poor worldwide. In this context, a more rigorous approach, such as the one proposed by the ESC 2024 hypertension guidelines, can help to avoid the dark scenario related to this important CVD. Purpose Evaluate the impact of the ESC 2024 hypertension guidelines, through comparative analysis, with ESC 2018 hypertension guidelines on a population sample from a region where the majority of the population is white and of European ascendance. Methods Collection of basic sociodemographic data, history of risk factors and cardiometabolic diseases, blood pressure measurement as recommended in guidelines, and anthropometric measurements of adult volunteers randomly approached in a place with high traffic of people. The results were expressed in percentages and percentage points. Results A total of 504 individuals were evaluated, 50.5% men and 49.5% women, with a mean age of 59.56 years. 49.21% had a history of hypertension (HH), 46.02% were sedentary, 23.4% had a normal body mass index, 36% were overweight, 40.6% were obese, 21.42% had diabetes, and 33.53% had dyslipidemia. Among individuals with HH, 70% had regular medical follow-ups, 84.6% used medication regularly, 40.73% had blood pressure (BP) <140/90 mmHg, and 11.70% had BP <130/80 mmHg. Among those without HH, 36.72% had BP ≥ 140/90 mmHg, 59.38% had elevated BP, and 3.9% had non-elevated BP. Applying the criteria proposed in 2018, 40.73% of those with HH reached the initial treatment target, 11.72% of those without HH had BP between 130/85 and <140/90 (high normal BP), 30.86% between 120/80 and <130/85 (norma BPl ), and 20.70% BP <120/80 (optimal BP). Applying the 2024 criteria, 11.70% of those with HH reached the treatment target (BP <130/80 mmHg), 59.38% of those without HH had BP ≥ 120/70 and <140/90 (elevated BP) and 3.9% BP <120/70 mmHg (non-elevated BP). Conclusion(s) Based on the 2024 recommendations, in this population sample, compared to the 2018 recommendations, the percentage of blood pressure control was almost 29 percentage points lower, the percentage of individuals with blood pressure levels below 140/90 mmHg, requiring diagnostic clarification, was 47 percentage points higher. In addition, the percentage of individuals not requiring a specific approach reduced by more than 16 percentage points. Therefore, the ESC 2024 hypertension guidelines will contribute mainly to reducing therapeutic inertia, one of the causal factors behind the low overall percentage of therapeutic goal achievement.Prevalence and sample characteristics