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September 14, 2026BMC Family PracticeOpen Access

Applying the 2024 ESC guidelines reduced the proportion of patients with non-elevated blood pressure from 70.5% to 17.1% compared to the 2018 criteria.

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Why the study?

The 2024 ESC guidelines revised office BP classification below the hypertension threshold, but data on the impact of these changes on primary care practice were limited.

Does applying the 2024 ESC guidelines alter office blood pressure classification and target achievement compared to 2018 guidelines in primary care patients?

Population

882 individuals aged 18 years or older registered at a family health center in Izmir

Comparison

2024 ESC guidelines vs 2018 ESC/ESH guidelines

Design

Retrospective cross-sectional study

Key result

Applying the 2024 ESC guidelines reduced the proportion of patients with non-elevated blood pressure from 70.5% to 17.1% compared to the 2018 criteria.

Authors

İÇİsmail ÇifçiEKEsra Meltem Koç

Discussion

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Member takes

Overview

Reclassifies office BP in primary care patients per 2024 ESC; leaves open effects on risk-based management decisions.

Key Points

  • To evaluate the reclassification of office blood pressure categories and the achievement of target levels among primary care patients under the 2024 European Society of Cardiology guidelines compared with 2018 criteria.
  • Retrospective cross-sectional study evaluating 882 individuals aged 18 years or older registered at a family health center in Izmir, Turkey.
  • Classified participants according to the 2018 ESC/ESH and 2024 ESC criteria, estimating cardiovascular risk using SCORE2 and SCORE2-OP algorithms.
  • Applying 2024 ESC criteria categorized 53.4% of all participants as having elevated blood pressure, leaving only 17.1% classified as non-elevated compared to 70.5% with non-hypertensive levels under 2018 guidelines.
  • Among participants with blood pressure below the diagnostic hypertension threshold, 75.7% were reclassified into the new elevated blood pressure category.
  • The rate of treated patients meeting blood pressure targets fell from 53.5% under the 2018 criteria to 30.8% under the 2024 targets.

Study Design

Type

Cross-Sectional (n=882)

Multicenter

No

Structured PICO

Does applying the 2024 ESC guidelines alter office blood pressure classification and target achievement compared to 2018 guidelines in primary care patients?

P
Population
882 individuals aged 18 years or older registered at a family health center in Izmir, assessed for blood pressure reclassification.
E
Exposure
Classification of office blood pressure according to the 2024 European Society of Cardiology (ESC) guidelines
C
Comparator
Classification according to the 2018 ESC/European Society of Hypertension (ESH) guidelines
O
Outcome
Change in office blood pressure classificationsurrogate

Main Result

Absolute Event Rate: 17.1% vs 70.5%

The implementation of the 2024 ESC guidelines significantly increases the proportion of patients classified with elevated blood pressure and decreases the rate of target achievement compared to the 2018 guidelines, likely impacting primary care workload.

Cite This Study

Çifçi et al. (2026) conducted a cross-sectional in Hypertension and elevated blood pressure (n=882). 2024 ESC guidelines vs. 2018 ESC/ESH guidelines was evaluated on change in office BP classification (proportion with non-elevated BP). Applying the 2024 ESC guidelines reduced the proportion of patients with non-elevated blood pressure from 70.5% to 17.1% compared to the 2018 criteria.

synapsesocial.com/papers/6aa7b2f70926e14a848b1822https://doi.org/10.1186/s12875-026-03553-6
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