2024-09-06 13:19:38
Doctors have recently issued new recommendations for high blood pressure – and introduced a risk category of “high blood pressure”. What those affected should know.
High blood pressure is a widespread health problem. But when does one actually speak of hypertension? The latest guidelines from the European Society of Cardiology (ESC) bring fresh air to the discussion.
A new guideline for high blood pressure was presented at the European Cardiology Congress in London at the end of August. The recommendations could lead to intense debates among the medical profession, as they differ in several points from the “National Hypertension Care Guideline” applicable in this country. The ESC experts are now recommending stricter blood pressure targets and introducing a new category for high blood pressure.
Elevated blood pressure is defined as being in the range of 120 to 139 mmHg systolic and 70 to 89 mmHg diastolic. High blood pressure (hypertension), on the other hand, remains defined as a blood pressure of 140/90 mmHg or higher.
The new category was introduced to consider more intensive blood pressure treatment for people with an increased risk of cardiovascular disease, especially stroke and heart attack, according to a statement from the ESC. “This new category of high blood pressure takes into account the fact that people do not go from normal blood pressure to high blood pressure overnight,” say the experts. Rather, it is a steady increase in the values.
In addition, various subgroups of patients in this category, such as those at higher risk for cardiovascular disease, may benefit from treatment before they cross the threshold for hypertension.
The guideline provides a differentiated treatment strategy for people with high blood pressure. This means that direct drug treatment is not necessary. First of all, it is important to determine the cardiovascular risk.
People with underlying diseases such as heart problems, chronic kidney disease or diabetes should therefore initially make lifestyle changes for three months (see below). If blood pressure is still above 130/80 mmHg, drug therapy should be started. Read here what you should do if the high blood pressure medication does not work.
In addition, stricter lifestyle changes are generally recommended. All adults with high blood pressure or hypertension should:
As a further innovation, the ESC experts are introducing a target range for systolic blood pressure, namely 120 to 129 mmHg for most patients who receive antihypertensive medication. This applies to everyone who tolerates the treatment well. For the rest, the systolic blood pressure target should be “as low as reasonably achievable,” the guideline states.
For high blood pressure values of 140/90 mmHg and above, treatment with a low-dose combination of two drugs, consisting of an ACE inhibitor or angiotensin receptor blocker and/or a calcium channel blocker and/or a diuretic, should be used. This differs significantly from previous guidelines, which only recommend this for a systolic value of 160 mmHg and above, and for high cardiovascular risk, for 140 mmHg and above.
In summary, the new hypertension guideline brings with it some significant changes: stricter target blood pressure values and lifestyle recommendations, and for the first time an intermediate threshold between normal blood pressure and high blood pressure – “high blood pressure”.