Antihypertensive treatment - achievements and perspectives in Europe by 2026 Italian, Swiss and Norwegian patient care

PURPOSE: The aim of this perspective review paper is to provide a concise overview of selected aspects of contemporary hypertension care in Norway, Switzerland, and Italy; European countries with populations of approximately 5.5, 9, and 61 million inhabitants, respectively. These countries show remarkably similar prevalences of hypertension, as well as comparable proportions of hypertensive patients who are diagnosed, treated, and controlled. METHODS: Each country has contributed to the development of hypertension management in distinctive ways. This is illustrated by the evolution of hypertension care in the three countries-which advanced hypertension management through different but complementary contributions. RESULTS: Italy has provided extensive clinical and research expertise, together with sustained engagement in the European Society of Hypertension and in the development of European guidelines. Norway has been strongly involved in the design and conduct of many large clinical trials that helped define the clinical evidence base in the field, and with general practitioners as investigators. Also, the government financed major surveys and epidemiological studies with blood pressure (BP) as a key variable including collecting data for modern risk assessment in old people (SCORE2-Old People). Switzerland, for its part, made important contributions to the development of new antihypertensive drugs, particularly blockers of the renin-angiotensin system and calcium antagonists. Switzerland was also among the first European countries to accept, promote, and reimburse ambulatory blood pressure monitoring performed by general practitioners, already by the late 1980s. CONCLUSION: We summarize novelties in text boxes besides basic principles, recent clarifications, and important unresolved issues, supported by selected key references.