New advances in the treatment and diagnosis of hypertension in primary care: a literature review

Background: Despite the availability of safe and effective antihypertensive drugs, hypertension continues to be a major risk factor for cardiovascular death and morbidity worldwide. This review explores the contemporary landscape of advances in hypertension (HTN) diagnosis and treatment, examining the discordant diagnostic thresholds proposed by American and European guidelines. Methods: An integrative approach was employed, analyzing pertinent literature from sources such as ScienceDirect, Google Scholar, and PubMed. Inclusion criteria encompassed studies on new advances in HTN diagnosis and treatment in primary care, published in English within the last five years (2018-2023). Results: Diagnostic innovations focus on the preference for automated sphygmomanometers and technological advancements, enhancing precision and reliability. Treatment advancements span neurovascular dimensions, including neuromodulation, and innovations in the renin-angiotensin-aldosterone system, showcasing promising drugs like finerenone and esaxerenone. Sodium-glucose cotransporter-2 inhibitors demonstrate efficacy beyond antidiabetic effects. The complexities of renal denervation and its challenges are scrutinized, emphasizing the need for further research. Clinical decision-making underscores risk stratification, lifestyle modifications, and the emerging use of single-pill combinations and individualized treatment plans. Conclusion: The review highlights the multidimensional approach required for optimal HTN management in primary care, encompassing diagnostic innovations, treatment advancements, and individualized strategies. Ongoing research is pivotal for refining diagnostic and therapeutic paradigms in hypertension management.