2023-07-10 16:40:20
New Guideline Recommends Regular Screening for High Blood Pressure in Patients with Sleep Apnea and Depression
A new guideline presented at the congress of the European Society of Hypertension (ESH) has recommended that doctors regularly screen patients with sleep apnea and depression for high blood pressure. The guideline, which was unveiled at the end of May 2023 in Milan, also defines new risk factors and comorbidities for arterial hypertension.
Arterial hypertension, commonly known as high blood pressure, is a chronic disease that can lead to serious complications such as stroke, heart attack, and renal failure. The new ESH guideline aims to raise awareness among healthcare professionals about the various risk factors and comorbidities associated with hypertension.
One of the significant updates in the guideline is the inclusion of sleep disorders, including obstructive sleep apnea syndrome, and depression as risk factors for arterial hypertension. Patients with these conditions should undergo regular screening tests for high blood pressure. Other newly identified risk factors include COPD, chronic inflammatory diseases, non-alcoholic fatty liver disease, chronic infections (including COVID-19), migraine, air pollution, high blood pressure-related complications during pregnancy, early onset of menopause, a migration background, and gender reassignment hormone therapy in transgender individuals.
“It is important to know these connections and to screen people with these diagnoses specifically for high blood pressure or, if hypertension is known, to keep in mind the increased cardiovascular risk of those affected,” said Prof. Markus van der Giet, Chairman of the German Hypertension League. He emphasized the importance of all doctors being aware of the new risk factors and conducting regular blood pressure measurements in patients with these conditions.
The new guideline also introduces a classification system for hypertension based on the degree of organ damage caused by high blood pressure. It divides hypertension into three classes: stage 1, which refers to uncomplicated hypertension without organ damage; stage 2, which indicates slight organ damage; and stage 3, which signifies the presence of heart or vascular diseases or advanced chronic kidney disease.
In terms of target values for blood pressure, the guideline recommends initiating drug therapy at values above 140/90 mm Hg. The goal is to reduce blood pressure to values below 140/80 mm Hg in all patients, with further reductions to values below 130/80 mm Hg for adults under 65 and older individuals who can tolerate it. However, the guideline emphasizes the importance of individualized risk assessment before initiating drug therapy.
The guideline also highlights the role of lifestyle modifications, such as a healthy diet, weight loss, exercise, and stress reduction, in managing high blood pressure.
In cases where optimal drug therapy fails to control blood pressure, renal denervation—a procedure that involves disrupting the nerves in the kidneys—can be considered as an additional treatment option. However, the guideline recommends that renal denervation be performed in specialized centers.
Alongside the ESH guideline, the National Care Guideline (NVL) Hypertension was also published, aligning with many of the recommendations outlined in the ESH guideline. Both guidelines emphasize the importance of individualized therapy, with the NVL setting a target value for hypertension at <140/90 mmHg. The difference in diastolic target value between the two guidelines is considered to have little practical relevance, with focus primarily on the systolic value.Despite minor differences, both guidelines aim to improve the management of arterial hypertension and reduce the risk of complications associated with high blood pressure. The German Hypertension League has welcomed the new guideline and will work towards its rapid implementation in clinical practice.] #Hypertension #screened #today #DocCheck