Management of ‘Elevated’ blood pressure according to the 2024 European Society of Cardiology Guidelines: lack of supportive evidence and high risk of excessive treatment

Q: What is the clinical evidence from this study?

Study design: Editorial. Population: Elevated blood pressure. Intervention: Antihypertensive treatment.

Q: What does this research mean for the field?

The 2024 ESC guidelines recommending antihypertensive drug treatment for 'Elevated' blood pressure lack supportive randomized trial evidence and pose a substantial risk of overtreatment. Novelty: ClaimNovelty.CONTRADICTORY. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

Sverre E. Kjeldsen; Mattias Brunström; Michel Burnier; Brent M. Egan; Krzysztof Narkiewicz; Reinhold Kreutz; Giuseppe Mancia

doi:10.1080/08037051.2025.2480608

March 17, 2025Blood PressureOpen Access

Management of ‘Elevated’ blood pressure according to the 2024 European Society of Cardiology Guidelines: lack of supportive evidence and high risk of excessive treatment

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Key result

The 2024 ESC guidelines recommending antihypertensive treatment for 'Elevated' blood pressure (120-139/70-89 mmHg) lack supportive evidence from randomized controlled trials and risk excessive treatment.

Why the study?

Does antihypertensive treatment prevent cardiovascular, cerebral, or renal complications in healthy individuals with 'Elevated' blood pressure (120-139/70-89 mmHg)?

Structured PICO

Does antihypertensive treatment prevent cardiovascular, cerebral, or renal complications in healthy individuals with 'Elevated' blood pressure (120-139/70-89 mmHg)?

P

Population

Healthy individuals with 'Elevated' blood pressure (120-139/70-89 mmHg) without previous cardiovascular events (primary prevention).

I

Intervention

Antihypertensive or blood pressure lowering treatment

Limitations

This is an editorial and does not present new primary clinical trial data.
The arguments are based on critical appraisal of existing meta-analyses and guidelines.

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

This editorial challenges the 2024 ESC Hypertension Guidelines, arguing that recommending antihypertensive therapy for 'Elevated' BP (120-139/70-89 mmHg) lacks robust RCT evidence and risks overburdening healthcare systems.

Abstract

The 2024 ESC Hypertension Guidelines and Treatment of “Elevated” BPThe 2024 European Society of Cardiology (ESC) hypertension guidelines (2024 ESC-HTGL) has introduced a new blood pressure (BP) cat...

Discussion

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Cite This Study

Kjeldsen et al. (2025) conducted an editorial in Elevated blood pressure. Antihypertensive treatment was evaluated. The 2024 ESC guidelines recommending antihypertensive treatment for 'Elevated' blood pressure (120-139/70-89 mmHg) lack supportive evidence from randomized controlled trials and risk excessive treatment.

synapsesocial.com/papers/6aac9c2f4963efd150c0cff5 https://doi.org/10.1080/08037051.2025.2480608

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Management of ‘Elevated’ blood pressure according to the 2024 European Society of Cardiology Guidelines: lack of supportive evidence and high risk of excessive treatment

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Management of ‘Elevated’ blood pressure according to the 2024 European Society of Cardiology Guidelines: lack of supportive evidence and high risk of excessive treatment

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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