Controversies in the management of patients with arterial hypertension

Every 5 to 6 years, international and national guidelines provide updated recommendations for the standard management of hypertension in adults. Thus, within the last 18 months, societies from Europe (European Society of Cardiology and European Society of Hypertension), America (American College of Cardiology and American Heart Association), and Great Britain (National Institute for Health and Care Excellence) published their new guidelines. Despite the fact that all of them are supposedly based on the most recent clinical evidence, there are always some discrepancies between recommendations due to different interpretation of clinical trials. The purpose of the present review is to discuss 6 issues that have generated some controversies, namely, the definition of hypertension, identification of patients who should be treated, target blood pressure, pertinence of reducing salt intake, and the role of renal denervation in resistant hypertension.