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May 22, 2025Heart

Applying the 2024 European Society of Cardiology Guidelines for the management of elevated blood pressure and hypertension to a Norwegian general population cohort from age 40: data from the Akershus Cardiac Examination 1950 study

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Why the study?

The 2024 ESC hypertension guidelines introduced an elevated BP category with potential pharmacological treatment for persistent elevated BP and high cardiovascular risk, but the impact on treatment eligibility and long-term cardiovascular event rates was unassessed.

Does the application of the 2024 ESC hypertension guidelines for elevated blood pressure accurately identify individuals who will experience MACE over 30 years in a general population cohort?

Population

2688 individuals born in 1950 in a Norwegian general population cohort

Comparison

Eligibility for pharmacological treatment under 2024 ESC guidelines vs non-eligibility

Design

Registry-linked cohort study

Follow-up

Over 30 years

Authors

HIHåkon Ihle‐HansenMWMarte Meyer Walle‐HansenGHGuri Hagberg

Discussion

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Member takes

Overview

Most MACE occurred outside 2024 ESC treatment-eligible groups; leaves open whether thresholds need refinement for long-term prediction.

Structured PICO

Does the application of the 2024 ESC hypertension guidelines for elevated blood pressure accurately identify individuals who will experience MACE over 30 years in a general population cohort?

P
Population
2,688 individuals born in 1950 from a Norwegian general population cohort (Age 40 Programme and Akershus Cardiac Examination 1950 Study), with blood pressure measurements at age 40 and 62-65.
I
Intervention
Application of the 2024 European Society of Cardiology (ESC) Guidelines for hypertension (specifically the 'elevated BP' category of 120-139/70-89 mm Hg and pharmacological treatment eligibility for persistent eBP 130-139/80-89 mm Hg with elevated CV risk).
O
Outcome
Treatment eligibility at ages 40 and 62-65, and major adverse cardiovascular events (MACEs) over 30 years of follow-up.composite

Applying the 2024 ESC hypertension guidelines to a 40-year-old cohort identified many with elevated BP, but the vast majority of subsequent MACE occurred in individuals who were not eligible for medical treatment under these criteria.

Cite This Study

Ihle‐Hansen et al. (2025) studied this question.

synapsesocial.com/papers/6a7f549d375bfe41b7b3d70ahttps://doi.org/10.1136/heartjnl-2025-325770
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prevalence of atrial fibrillation and cardiovascular risk factors in a 63–65 years old general population cohort: the Akershus Cardiac Examination (ACE) 1950 Study2018 · 44 citations
  2. 22024 ESC Guidelines for the management of elevated blood pressure and hypertension2024 · 2,312 citations
  3. 3Heart rate and mortality from cardiovascular causes: a 12 year follow-up study of 379 843 men and women aged 40-45 years2008 · 144 citations
  4. 4Heart and Brain Interactions--the Akershus Cardiac Examination (ACE) 1950 Study Design.2015 · 35 citations
  5. 52018 ESC/ESH Guidelines for the management of arterial hypertension2018 · 10,595 citations