December 31, 2024Hypertension22 citationsOpen Access
View Full PaperWhat Is New and Different in the 2024 European Society of Cardiology Guidelines for the Management of Elevated Blood Pressure and Hypertension?
Structured PICO
P
Population
Individuals with elevated blood pressure or hypertension
I
Intervention
2024 European Society of Cardiology guidelines for the management of elevated blood pressure and hypertension
C
Comparator
Other major international hypertension guidelines in Europe and America
This review summarizes the 2024 ESC hypertension guidelines, highlighting the new BP categorization and the default systolic BP treatment target of 120-129 mm Hg, to help clinicians reconcile differences with other international guidelines.
Abstract
In 2024, the European Society of Cardiology released a new guideline for the management of elevated blood pressure (BP) and hypertension. The guideline introduced a new BP categorization: (1) nonelevated (office BP <120/70 mm Hg) for which drug treatment is not recommended, (2) elevated (120-139/70-89 mm Hg) for which drug treatment is recommended based on cardiovascular disease risk and follow-up BP level, and (3) hypertension (≥140/90 mm Hg) for which prompt confirmation and drug treatment are recommended in most individuals. The initial default systolic BP treatment target is 120 to 129 mm Hg; however, relaxed targets (BP as low as reasonably achievable) are recommended in case of treatment intolerance, adults ≥85 years, symptomatic orthostasis, moderate-to-severe frailty, or limited life expectancy. Here, we summarize what is new and different in the 2024 European Society of Cardiology guidelines, relative to other major international hypertension guidelines in Europe and America. Our aim is to reconcile any uncertainty clinicians may have about implementing these various guidelines in patient care.