Key result
Medical guidelines for essential hypertension from 2003 to 2013 have evolved to resolve controversies in blood pressure goals, initial therapy levels, and pharmacological choices.
This review summarizes the evolution of hypertension management guidelines over a decade, highlighting shifts in blood pressure targets and pharmacological strategies.
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Clinicians should monitor evolving hypertension guidelines; this Level 5 review leaves open questions for updated trials on targets and therapies.
This article aims to discuss differences in pharmacological treatment through a period of 10 years from 2003 to 2013. Hypertension treatment faces many challenges because of patients' unawareness and adherence, clinical inertia, as well as rapid availability of new medical literature and trials. Since 2003, JNC 7 was published at nearly the same time with ESC/ESH Guidelines and WHO/ISH Statement on management of hypertension [1–3]. However, these guidelines are not homogenous in pharmacological therapy approach. Moreover, during the 10 years since 2003, many new large trials, data, and updated guidelines have resolved some main controversial problems in blood pressure (BP) goals in separate risk-categorized patients, levels of BP for initial antihypertensive therapy, choice of drugs in monotherapy, indication for drug combinations, and preferred combinations for special cases. The latest updated guidelines on hypertension treatment, 2013 ESC/ESH Guidelines for the management of arterial hypertension, not only contain significant changes in the abovementioned problems, but also raise some new questions for the future research [4].
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Tran et al. (2014) conducted a review in Essential hypertension. Medical guidelines for hypertension (2003-2013) was evaluated. Medical guidelines for essential hypertension from 2003 to 2013 have evolved to resolve controversies in blood pressure goals, initial therapy levels, and pharmacological choices.
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