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Journal Article•DOI•

2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension.

Giuseppe Mancia, Robert Fagard1, Krzysztof Narkiewicz2, Josep Redán3, Alberto Zanchetti, Michael Böhm, Thierry Christiaens4, Renata Cifkova5, Guy De Backer4, Anna F. Dominiczak6, Maurizio Galderisi7, Diederick E. Grobbee8, Tiny Jaarsma9, Paulus Kirchof10, Sverre E. Kjeldsen11, Stéphane Laurent, Athanasios J. Manolis, Peter M. Nilsson, Luis M. Ruilope12, Roland E. Schmieder13, Per Anton Sirnes, Peter Sleight14, Margus Viigimaa15, Bernard Waeber16, Faiez Zannad •
Katholieke Universiteit Leuven1, Gdańsk Medical University2, University of Valencia3, Ghent University4, Charles University in Prague5, University of Glasgow6, University of Naples Federico II7, Utrecht University8, Linköping University9, University of Münster10, University of Oslo11, Complutense University of Madrid12, University of Erlangen-Nuremberg13, John Radcliffe Hospital14, Tallinn University of Technology15, University of Lausanne16
01 Oct 2013-Journal of Hypertension (Lippincott Williams & Wilkins)-Vol. 31, Iss: 10, pp 1925-1938
TL;DR: The 2013 European Society of Hypertension/European Society of Cardiology (ESH/ESC) guidelines continue to adhere to some fundamental principles that inspired the 2003 and 2007 guidelines, namely to base recommendations on properly conducted studies identified from an ext
Abstract: 1. INTRODUCTION1.1 PrinciplesThe 2013 European Society of Hypertension/European Society of Cardiology (ESH/ESC) guidelines continue to adhere to some fundamental principles that inspired the 2003 and 2007 guidelines, namely to base recommendations on properly conducted studies identified from an ext

Summary (3 min read)

Jump to: [1. INTRODUCTION] – [1.1. Principles] – [1. 3 New concepts] – [2. Definitions and classifications] – [3.1 Evaluation of the CV risk] – [3.2 Measurement of blood pressure] – [4. Treatment of hypertension] – [4.1 Drug treatment strategy and blood pressure targets (Figure 15-20)] – [4.4. Resistant hypertension (Figures 26 and 27)] – [5.1 Frequency of visits] and [5.2 Adherence to therapy (Figure 43)]

1. INTRODUCTION

  • These 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines for the management of arterial hypertension are designed for adults with hypertension, i.e. aged ≥18 years.
  • The purpose of the review and update of these guidelines was to evaluate and incorporate new evidence into the guideline recommendations.
  • The specific aims of these guidelines were to produce pragmatic recommendations to improve the detection and treatment of hypertension, and to improve the poor rates of BP control by promoting simple and effective treatment strategies.

1.1. Principles

  • (i) to base recommendations on properly conducted studies, identified from an extensive review of the literature; (ii) to give the highest priority to data from randomized, controlled trials (RCTs); (iii) to also consider well-conducted meta-analyses of RCTs as strong evidence, also known as These fundamental principles are.
  • In these circumstances, the authors resort to pragmatic expert opinion and endeavour to explain its rationale.

1. 3 New concepts

  • BP measurement - Wider use of out-of-office BP measurement with ABPM and/or HBPM, especially HBPM, as an option to confirm the diagnosis of hypertension, detect white coat and masked hypertension and monitor BP control.
  • Less conservative treatment of BP in older and very old patients - Lower BP thresholds and treatment targets for older patients – with emphasis on considerations of biological rather than chronological age (i.e. the importance of frailty, independence, and the tolerability of treatment).
  • A SPC treatment strategy to improve BP control - Preferred use of two-drug combination therapy for the initial treatment of most people with hypertension. - A single-pill treatment strategy for hypertension with the preferred use SPC therapy for most patients.
  • - Simplified drug-treatment algorithms with the preferred use of an ACE inhibitor or ARB combined with a CCB or/and a thiazide/thiazide-like diuretic as the core treatment strategy for most patients, with beta-blockers used for specific indications.
  • The important role of nurses and pharmacists in the education, support, and follow-up of treated hypertensive patients is emphasized as part of the overall strategy to improve BP control.

2. Definitions and classifications

  • The relationship between BP and CV and renal events is continuous, making the distinction between normotension and hypertension − based on cut-off BP values − somewhat arbitrary.
  • This evidence has been reviewed and provides the basis for the recommendation that the classification of BP and definition of hypertension remain unchanged from previous ESH/ESC guidelines.

3.1 Evaluation of the CV risk

  • Many CV risk-assessment systems are available and most project 10-year risk.
  • Since 2003, the European guidelines on CVD prevention have recommended use of the Systematic COronary Risk Evaluation system because it is based on large, representative European cohort datasets (available at: http://www.escardio.org/Guidelines-&-Education/Practice-tools/CVD-preventiontoolbox/-Risk-Charts).
  • The SCORE system only estimates the risk of fatal CV events.

3.2 Measurement of blood pressure

  • Auscultatory or oscillometric semiautomatic or automatic sphygmomanometers are the preferred method for measuring BP in the doctor’s office.
  • These devices should be validated according to standardized conditions and protocols.
  • In white-coat hypertension, the difference between the higher office and the lower out-of-office BP is referred to as the “white-coat effect”, and is believed to mainly reflect the pressor response to an alerting reaction elicited by office BP measurements by a doctor or a nurse, although other factors are probably also involved.
  • These guidelines also support the use of out-of-office BP (i.e. HBPM and/or ABPM) as an alternative strategy to repeated office BP measurements, to confirm the diagnosis of hypertension, when these measurements are logistically and economically feasible.
  • All adults should have their BP recorded in their medical record and be aware of their BP, and further screening should be undertaken at regular intervals with the frequency dependent on the BP level as illustrated in Figure 10.

4. Treatment of hypertension

  • The routine treatment of hypertension involves lifestyle interventions for all patients (including those with high normal BP) and drug therapy for most patients.
  • All guidelines agree that patients with grade 2 or 3 hypertension should receive antihypertensive drug treatment alongside lifestyle interventions.
  • Guidelines are also consistent in recommending that patients with grade 1 hypertension and high CV risk or HMOD should be treated with BP-lowering drugs.
  • There has been less consistency about whether BP-lowering drugs should be offered to patients with grade 1 hypertension and low-to-moderate CV risk or grade 1 hypertension in older patients (> 60 years), or the need for BP-lowering drug treatment in patients with high-normal BP levels.
  • This uncertainty relates to the fact that low-risk patients with high-normal BP or grade 1 hypertension have rarely been included in RCTs, and that in older patients, RCTs have invariably recruited patients with at least grade 2 hypertension.

4.1 Drug treatment strategy and blood pressure targets (Figure 15-20)

  • Figure 16: Summary of office BP thresholds for treatment CAD: coronary artery disease; CKD: chronic kidney disease; SBP: systolic blood pressure; TIA: transient ischaemic attack.
  • Figure 17: Office BP treatment targets in hypertensive: recommendations.
  • The level to which BP should be lowered with drug treatment will depend on the patients’ age, comorbidities and tolerability of treatment.
  • The core algorithm is also appropriate for most patients with HMOD, cerebrovascular disease, diabetes, or peripheral artery disease.

4.4. Resistant hypertension (Figures 26 and 27)

  • Hypertension is defined as resistant to treatment when the recommended treatment strategy fails to lower office SBP and DBP values to below 140 mmHg and/or 90 mmHg, respectively, and the inadequate control of BP is confirmed by ABPM or HBPM, in patients whose adherence to therapy has been confirmed.
  • The recommended treatment strategy should include appropriate lifestyle measures and treatment with optimal or best-tolerated doses of three or more drugs that should include a diuretic and typically an ACE inhibitor or ARB, and a CCB.

5.1 Frequency of visits

  • After the initiation of antihypertensive drug therapy, it is important to review the patient at least once within the first 2 months to evaluate the effects on BP and assess possible side-effects until BP is under control.
  • The frequency of review will depend on the severity of hypertension, the urgency to achieve BP control, and the patient’s comorbidities.
  • Patients with high-normal BP or white-coat hypertension frequently have additional risk factors, including HMOD, and have a higher risk of developing sustained hypertension.
  • Thus, even when untreated, they should be scheduled for regular follow-up (at least annual visits) to measure office and out-of-office BP, as well as to check the CV risk profile.

5.2 Adherence to therapy (Figure 43)

  • Non-adherence to antihypertensive therapy correlates with higher risk of CV events.
  • The levels of evidence for each of the recommendations presented in the figures can be found in the original publications cited below.
  • The grading scale can be found as supplementary material .
  • Guidelines for the management of arterial hypertension.

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Content maybe subject to copyright    Report

Williams, B. et al. (2018) 2018 Practice guidelines for the management of arterial
hypertension of the European Society of Hypertension (ESH) and the European Society
of Cardiology (ESC). Blood Pressure, 27(6), pp. 314-340.
There may be differences between this version and the published version. You are
advised to consult the publisher’s version if you wish to cite from it.
http://eprints.gla.ac.uk/173246/
Deposited on: 8 January 2019
Enlighten – Research publications by members of the University of Glasgow
http://eprints.gla.ac.uk
1
2018 Practice guidelines for the management of arterial
hypertension of the European Society of Hypertension
(ESH) and the European Society of Cardiology (ESC)
ESH/ESC Task Force for the Management of Arterial Hypertension
List of authors/Task Force members
Bryan Williams (ESC Chairperson) (UK), Giuseppe Mancia (ESH Chairperson) (Italy),
Wilko Spiering (The Netherlands), Enrico Agabiti Rosei (Italy), Michel Azizi (France), Michel
Burnier (Switzerland), Denis Clement (Belgium), Antonio Coca (Spain), Giovanni De Simone (Italy),
Anna Dominiczak (UK), Thomas Kahan (Sweden), Felix Mahfoud (Germany), Josep Redon (Spain),
Luis Ruilope (Spain), Alberto Zanchetti †, Mary Kerins (Ireland), Sverre Kjeldsen (Norway),
Reinhold Kreutz (Germany), Stephane Laurent (France), Gregory Y. H. Lip(UK), Richard Mcmanus
(UK), Krzysztof Narkiewicz (Poland), Frank Ruschitzka (Switzerland),Roland Schmieder (Germany),
Evgeny Shlyakhto (Russia), Konstantinos Tsioufis (Greece),Victor Aboyans (France), Ileana
Desormais (France).
ESH Practice Guidelines writing Task Force
Michel Burnier, Sverre E. Kjeldsen, Guido Grassi, Krzysztof Narkiewicz, Gianfranco Parati, Reinhold
Kreutz, Konstantinos Tsioufis, Bryan Williams, Giuseppe Mancia.
†Professor Zanchetti died during the development of these Guidelines, in March 2018. He contributed
fully to the redaction of these Guidelines, as a member of the Guidelines’ Task Force and as a section
co-ordinator. He will be sadly missed by colleagues and friends.
Short Title: 2018 Practice Guidelines for the management of hypertension
Key words: Blood Pressure – Blood pressure measurement – Blood pressure
treatment thresholds and targets – Hypertension-mediated organ damage – Lifestyle
interventions – Drug therapy – Combination therapy – Device therapy – Secondary
hypertension- Special conditions- Adherence
Correspondence to:
Prof. Michel Burnier
Service of Nephrology and Hypertension
Rue du Bugnon 17
1011 Lausanne, Switzerland
Email: michel.burnier@chuv.ch
2
List of abbreviations
ABI, ankle–brachial index;
ABPM,ambulatory blood pressure monitoring;
ACE, angiotensin-converting enzyme;
ACEi, angiotensin-converting enzyme inhibitor;
ACR, albumin:creatinine ratio;
AF, Atrial fibrillation;
ARB,angiotensin receptor blocker;
AV, atrioventricular;
BP, blood pressure;
bpm, beats per minute;
BSA, body surface area;
CAD, coronary artery disease;
CKD, chronic kidney disease;
CVD, cardiovascular disease;
DHP, dihydropyridine;
eGFR, estimated glomerular filtration rate;
ESC, European Society of Cardiology;
ESH, European Society of Hypertension;
HbA1c, Haemoglobin A1c;
HBPM, Home blood pressure monitoring;
HDL-C, HDL-cholesterol;
HFpEF, heart failure with preserved ejection fraction;
HFrEF, heart failure with reduced ejection fraction;
HMOD, Hypertension mediated organ damage;
IMT, intima–media thickness;
LDLC, LDL cholesterol;
LEAD, lower extremity artery disease;
LV, left ventricular;
LVH, left ventricular hypertrophy;
MAP, mean arterial pressure;
MI, myocardial infarction;
MR, magnetic resonance;
MRA, mineralocorticoid receptor antagonist;
MUCH, Masked uncontrolled hypertension;
NTproBNP, N-terminal pro-B natriuretic peptide;
o.d., omni die (every day);
PAC, plasma aldosterone concentration;
PAD, peripheral artery disease;
PRA, plasma renin activity;
PRC, plasma renin concentration;
PWV, pulse wave velocity;
RAS, renin–angiotensin system;
RCT, randomized controlled trial;
RWT, relative wall thickness;
SPC, single-pill combination;
SUCH, sustained uncontrolled hypertension;
TIA, transient ischaemic attack;
TE, transthoracic echocardiography;
WUCH, white coat uncontrolled hypertension
3
Summary:
The key messages in 20 points
1. Blood pressure, epidemiology, and risk. Globally, over 1 billion people have hypertension. As
populations age and adopt more sedentary lifestyles, the worldwide prevalence of hypertension will
continue to rise towards 1.5 billion by 2025. Elevated BP is the leading global contributor to premature
death, accounting for almost 10 million deaths in 2015, 4.9 million due to ischaemic heart disease and
3.5 million due to stroke. Hypertension is also a major risk factor for heart failure, AF, CKD, PAD, and
cognitive decline.
2. Definition of hypertension. The classification of BP and the definition of hypertension is unchanged
from previous European guidelines, and is defined as an office SBP ≥ 140 and/or DBP ≥ 90 mmHg,
which is equivalent to a 24-h ABPM average of ≥ 130/80 mmHg, or a HBPM average ≥ 135/85 mmHg.
3. Screening and diagnosis of hypertension. Hypertension is usually asymptomatic (hence the term
“silent killer”). Because of its high prevalence, screening programmes should be established to ensure
that BP is measured in all adults, at least every 5 years and more frequently in people with a high-normal
BP. When hypertension is suspected because of an elevated screening BP, the diagnosis of hypertension
should be confirmed either by repeated office BP measurements, over a number of visits, or by out-of-
office BP measurement using 24-h ABPM or by HBPM.
4. The importance of cardiovascular risk assessment and detection of HMOD.
Other CV risk factors such as dyslipidaemia and metabolic syndrome frequently cluster with
hypertension. Thus, unless the patient is already at high or very high risk due to established CVD, formal
CV risk assessment is recommended using the SCORE system. It is important to recognise, however,
that the presence of HMOD, especially LVH, CKD, or advanced retinopathy, further increases the risk
of CV morbidity and mortality, and should be screened for as part of risk assessment in hypertensive
patients because the SCORE system alone may underestimate their risk.
5. Think – could this patient have secondary hypertension? For most people with hypertension, no
underlying cause will be detected. Secondary (and potentially remediable) causes of hypertension are
more likely to be present in people with young onset of hypertension (< 40 years), people with severe
or treatment-resistant hypertension, or people who suddenly develop significant hypertension in midlife
on a background of previously normal BP. Such patients should be referred for specialist evaluation.
6. Treatment of hypertension – importance of lifestyle interventions. The treatment of hypertension
involves lifestyle interventions and drug therapy. Many patients with hypertension will require drug
therapy, but lifestyle interventions are important because they can delay the need for drug treatment or
complement the BP-lowering effect of drug treatment. Moreover, lifestyle interventions such as sodium
restriction, alcohol moderation, healthy eating, regular exercise, weight control and smoking cessation,
all have health benefits beyond their impact on blood pressure.
7. When to consider drug treatment of hypertension. The treatment thresholds for hypertension are
now less conservative than they were in previous guidelines. We now recommend that patients with
low−moderate risk grade 1 hypertension (office BP 140–159/90–99), even if they do not have HMOD,
4
should now receive drug treatment if their BP is not controlled after a period of lifestyle intervention
alone. For higher risk patients with grade 1hypertension, including those with HMOD, or patients with
higher grades of hypertension (e.g. grade 2 hypertension, ≥ 160/100 mmHg), we recommend initiating
drug treatment alongside lifestyle interventions. These recommendations apply to all adults up to the
age of 80 years.
8. Special considerations in frail and older patients. It is increasingly recognised that biological rather
than chronological age, as well as consideration of frailty and independence, are important determinants
of the tolerability of and likely benefit from BP-lowering medications. It is important to note that even
in the very old (i.e. > 80 years), BP-lowering therapy reduces mortality, stroke, and heart failure. Thus,
these patients should not be denied treatment, or have treatment withdrawn simply on the basis of age.
For people > 80 years who have not yet received treatment for their BP, treatment is recommended
when their office SBP is ≥ 160 mmHg, provided that the treatment is well tolerated.
9. How low should SBP be lowered ? This has been a hotly debated topic. A key discussion point is
the balance of potential benefits versus potential harm or adverse effects. This is especially important
whenever BP targets are lowered, as there is a greater potential for harm to exceed benefit. Thus, in this
guideline, we recommend a target range. The evidence strongly suggests that lowering office SBP to <
140 mmHg is beneficial for all patient groups, including independent older patients. There is also
evidence to support targeting SBP to 130 mmHg for most patients, if tolerated. Even lower SBP levels
(< 130 mmHg) will be tolerated and potentially beneficial for some patients, especially to further reduce
the risk of stroke. SBP should not be targeted to below 120 mmHg because the balance of benefit versus
harm becomes concerning at these levels of treated SBP.
10. BP targets in old and very old patient. As discussed above, independence, frailty, and
comorbidities will all influence treatment decisions, especially in older (≥ 65 years) and very old (> 80
years) patients. The desired SBP target range for all patients aged > 65 years is < 140 mmHg but not <
130 mmHg. This is lower than in previous guidelines and may not be achievable in all older patients,
but any BP lowering towards this target is likely to be beneficial provided that the treatment is well
tolerated.
11. BP targets in patients with diabetes and/or CKD. The BP-treatment targets for patients with
diabetes or kidney disease have been a moving target in previous guidelines because of seemingly
contradictory results from major outcome trials and meta-analyses. For diabetes, targeting the SBP to <
140 mmHg and towards 130 mmHg, as recommended for all other patient groups, is beneficial on major
outcomes. Moreover, targeting SBP to < 130 mmHg, for those who will tolerate it, may further reduce
the risk of stroke but not other major outcomes. SBP should not be lowered below 120 mmHg. For
patients with CKD, the evidence suggests that the target BP range should be < 140 mmHg but not < 130
mmHg.
12. How low should DBP be lowered? The optimal DBP target has been less well defined, but a DBP
target of < 80 mmHg is recommended. Some patients with stiff arteries and isolated systolic
hypertension will already have DBP levels below this target. These are high risk patients and the low
DBP should not discourage treatment of their elevated SBP to the recommended target, provided that
treatment is well tolerated.
13. The need to do better on BP control. A key message in this guideline is the need to do better at
improving BP control rates. Despite the overwhelming evidence of treatment benefit, on average, < 50%
Citations
More filters
Journal Article•DOI•
European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (Version 2012)

[...]

Massimo Piepoli1, Arno W. Hoes, Stefan Agewall2, Christian Albus, Carlos Brotons, Alberico L. Catapano, Marie Therese Cooney2, Ugo Corrà, Bernard Cosyns2, Christi Deaton2, Ian D. Graham2, Michael Stephen Hall3, FD Richard Hobbs, Maja Lisa Løchen2, Herbert Löllgen, Pedro Marques-Vidal2, Joep Perk2, Eva Prescott2, Josep Redon4, Dimitrios J. Richter2, Naveed Sattar5, Y.M. Smulders2, Monica Tiberi2, H. Bart van der Worp, Ineke van Dis, W M Monique Verschuren2 •
Linnaeus University1, European Society of Cardiology2, International Diabetes Federation3, European Society of Hypertension4, European Association for the Study of Diabetes5
01 Jul 2012-European Heart Journal
TL;DR: In this paper, a randomized clinical trial was conducted to evaluate the effect of preterax and Diamicron Modified Release Controlled Evaluation (MDE) on the risk of stroke.
Abstract: ABI : ankle–brachial index ACCORD : Action to Control Cardiovascular Risk in Diabetes ADVANCE : Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation AGREE : Appraisal of Guidelines Research and Evaluation AHA : American Heart Association apoA1 : apolipoprotein A1 apoB : apolipoprotein B CABG : coronary artery bypass graft surgery CARDS : Collaborative AtoRvastatin Diabetes Study CCNAP : Council on Cardiovascular Nursing and Allied Professions CHARISMA : Clopidogrel for High Athero-thrombotic Risk and Ischemic Stabilisation, Management, and Avoidance CHD : coronary heart disease CKD : chronic kidney disease COMMIT : Clopidogrel and Metoprolol in Myocardial Infarction Trial CRP : C-reactive protein CURE : Clopidogrel in Unstable Angina to Prevent Recurrent Events CVD : cardiovascular disease DALYs : disability-adjusted life years DBP : diastolic blood pressure DCCT : Diabetes Control and Complications Trial ED : erectile dysfunction eGFR : estimated glomerular filtration rate EHN : European Heart Network EPIC : European Prospective Investigation into Cancer and Nutrition EUROASPIRE : European Action on Secondary and Primary Prevention through Intervention to Reduce Events GFR : glomerular filtration rate GOSPEL : Global Secondary Prevention Strategies to Limit Event Recurrence After MI GRADE : Grading of Recommendations Assessment, Development and Evaluation HbA1c : glycated haemoglobin HDL : high-density lipoprotein HF-ACTION : Heart Failure and A Controlled Trial Investigating Outcomes of Exercise TraiNing HOT : Hypertension Optimal Treatment Study HPS : Heart Protection Study HR : hazard ratio hsCRP : high-sensitivity C-reactive protein HYVET : Hypertension in the Very Elderly Trial ICD : International Classification of Diseases IMT : intima-media thickness INVEST : International Verapamil SR/Trandolapril JTF : Joint Task Force LDL : low-density lipoprotein Lp(a) : lipoprotein(a) LpPLA2 : lipoprotein-associated phospholipase 2 LVH : left ventricular hypertrophy MATCH : Management of Atherothrombosis with Clopidogrel in High-risk Patients with Recent Transient Ischaemic Attack or Ischaemic Stroke MDRD : Modification of Diet in Renal Disease MET : metabolic equivalent MONICA : Multinational MONItoring of trends and determinants in CArdiovascular disease NICE : National Institute of Health and Clinical Excellence NRT : nicotine replacement therapy NSTEMI : non-ST elevation myocardial infarction ONTARGET : Ongoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial OSA : obstructive sleep apnoea PAD : peripheral artery disease PCI : percutaneous coronary intervention PROactive : Prospective Pioglitazone Clinical Trial in Macrovascular Events PWV : pulse wave velocity QOF : Quality and Outcomes Framework RCT : randomized clinical trial RR : relative risk SBP : systolic blood pressure SCORE : Systematic Coronary Risk Evaluation Project SEARCH : Study of the Effectiveness of Additional Reductions in Cholesterol and SHEP : Systolic Hypertension in the Elderly Program STEMI : ST-elevation myocardial infarction SU.FOL.OM3 : SUpplementation with FOlate, vitamin B6 and B12 and/or OMega-3 fatty acids Syst-Eur : Systolic Hypertension in Europe TNT : Treating to New Targets UKPDS : United Kingdom Prospective Diabetes Study VADT : Veterans Affairs Diabetes Trial VALUE : Valsartan Antihypertensive Long-term Use VITATOPS : VITAmins TO Prevent Stroke VLDL : very low-density lipoprotein WHO : World Health Organization ### 1.1 Introduction Atherosclerotic cardiovascular disease (CVD) is a chronic disorder developing insidiously throughout life and usually progressing to an advanced stage by the time symptoms occur. It remains the major cause of premature death in Europe, even though CVD mortality has …

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Journal Article•DOI•
2016 European Guidelines on cardiovascular disease prevention in clinical practice

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Massimo Piepoli1, Arno W. Hoes2, Stefan Agewall1, Christian Albus, Carlos Brotons, Alberico L. Catapano, Marie Therese Cooney1, Ugo Corrà1, Bernard Cosyns1, Christi Deaton1, Ian D. Graham1, Michael Stephen Hall3, FD Richard Hobbs, Maja-Lisa Løchen1, Herbert Löllgen, Pedro Marques-Vidal1, Joep Perk1, Eva Prescott1, Josep Redon4, Dimitrios J. Richter1, Naveed Sattar5, Yvo M. Smulders1, Monica Tiberi1, H. Bart van der Worp, Ineke van Dis, W. M. Monique Verschuren1 •
European Society of Cardiology1, Utrecht University2, International Diabetes Federation3, European Society of Hypertension4, European Association for the Study of Diabetes5
01 Aug 2016-European Heart Journal
TL;DR: ABI is ankle-brachial (blood pressure) index and ABPM is ambulatory blood pressure monitoring as mentioned in this paper ; ACCORD is action to control cardiovascular risk in Diabetes and Vascular disease.
Abstract: ABI : ankle–brachial (blood pressure) index ABPM : ambulatory blood pressure monitoring ACCORD : Action to Control Cardiovascular Risk in Diabetes ACE-I : angiotensin-converting enzyme inhibitor ACS : acute coronary syndromes ADVANCE : Action in Diabetes and Vascular disease: PreterAx

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Journal Article•DOI•
2016 European Guidelines on cardiovascular disease prevention in clinical practice

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Massimo F Piepoli, Arno W. Hoes, Stefan Agewall, Christian Albus1, Carlos Brotons, Alberico L. Catapano, Marie Therese Cooney1, Marie Therese Cooney2, Ugo Corrà, Bernard Cosyns, Christi Deaton2, Christi Deaton3, Christi Deaton4, Ian D. Graham, Michael Stephen Hall5, Michael Stephen Hall1, FD Richard Hobbs, Maja Lisa Løchen2, Maja Lisa Løchen1, Herbert Löllgen, Pedro Marques-Vidal, Joep Perk, Eva Prescott, Josep Redon, Dimitrios J. Richter, Naveed Sattar, Yvo M. Smulders, Monica Tiberi1, Monica Tiberi2, H. Bart van der Worp, Ineke van Dis1, W. M. Monique Verschuren, Simone Binno6 •
Utrecht University1, European Society of Cardiology2, University of Leeds3, Karolinska Institutet4, International Diabetes Federation5, University of Parma6
09 Sep 2016-Kardiologia Polska
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Journal Article•DOI•
The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019)

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01 Sep 2019-Hypertension Research
TL;DR: The story of the life and times of Toshihiko Umemura and his family in the years leading up to and including his death.
Abstract: Satoshi Umemura ● Hisatomi Arima ● Shuji Arima ● Kei Asayama ● Yasuaki Dohi ● Yoshitaka Hirooka ● Takeshi Horio ● Satoshi Hoshide ● Shunya Ikeda ● Toshihiko Ishimitsu ● Masaaki Ito ● Sadayoshi Ito ● Yoshio Iwashima ● Hisashi Kai ● Kei Kamide ● Yoshihiko Kanno ● Naoki Kashihara ● Yuhei Kawano ● Toru Kikuchi ● Kazuo Kitamura ● Takanari Kitazono ● Katsuhiko Kohara ● Masataka Kudo ● Hiroo Kumagai ● Kiyoshi Matsumura ● Hideo Matsuura ● Katsuyuki Miura ● Masashi Mukoyama ● Satoko Nakamura ● Takayoshi Ohkubo ● Yusuke Ohya ● Takafumi Okura ● Hiromi Rakugi ● Shigeyuki Saitoh ● Hirotaka Shibata ● Tatsuo Shimosawa ● Hiromichi Suzuki ● Shori Takahashi ● Kouichi Tamura ● Hirofumi Tomiyama ● Takuya Tsuchihashi ● Shinichiro Ueda ● Yoshinari Uehara ● Hidenori Urata ● Nobuhito Hirawa

903 citations

Journal Article•DOI•
2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts): Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR).

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Massimo Piepoli1, Arno W. Hoes2, Stefan Agewall, Christian Albus, Carlos Brotons, Alberico L. Catapano2, Marie-Therese Cooney2, Ugo Corrà2, Bernard Cosyns2, Christi Deaton2, Ian D. Graham3, Michael Stephen Hall, F. D. Richard Hobbs2, Maja-Lisa Løchen, Herbert Löllgen2, Pedro Marques-Vidal2, Joep Perk2, Eva Prescott4, Josep Redon2, Dimitrios J. Richter5, Naveed Sattar2, Y.M. Smulders2, Monica Tiberi, H. Bart van der Worp, Ineke van Dis2, W M Monique Verschuren1, Additional Contributor: Simone Binno1, Guy De Backer1, Marco Roffi2, Victor Aboyans, Norbert Bachl2, Héctor Bueno2, Scipione Carerj2, Leslie Cho, John Cox2, Johan De Sutter2, Günther Egidi5, Miles Fisher2, Donna Fitzsimons2, Oscar H. Franco2, Maxime Guenoun2, Catriona Jennings, Borut Jug2, Paulus Kirchhof2, Kornelia Kotseva2, Gregory Y.H. Lip2, François Mach4, Giuseppe Mancia3, Franz Martin Bermudo2, Alessandro Mezzani2, Alexander Niessner2, Piotr Ponikowski2, Bernhard Rauch2, Lars Rydén, Adrienne Stauder, Guillaume Turc, Olov Wiklund2, Stephan Windecker2, José Luis Zamorano1 •
Utrecht University1, European Society of Cardiology2, International Diabetes Federation3, European Society of Hypertension4, European Association for the Study of Diabetes5
04 Jul 2012-European Journal of Preventive Cardiology

880 citations

Related Papers (5)
2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).

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21 Jul 2013-European Heart Journal
Giuseppe Mancia, Robert Fagard, Krzysztof Narkiewicz, Josep Redon, Alberto Zanchetti, Michael Böhm, Thierry Christiaens, Renata Cifkova, Guy De Backer, Anna F. Dominiczak, Maurizio Galderisi, Diederick E. Grobbee, Tiny Jaarsma, Paulus Kirchhof, Sverre E. Kjeldsen, Stéphane Laurent, Athanasios J. Manolis, Peter M. Nilsson, Luis M. Ruilope, Roland E. Schmieder, Per Anton Sirnes, Peter Sleight, Margus Viigimaa, Bernard Waeber, Faiez Zannad, Michel Burnier, Ettore Ambrosioni, Mark Caufield, Antonio Coca, Michael H. Olsen, Costas Tsioufis, Philippe van de Borne, José Luis Zamorano, Stephan Achenbach, Helmut Baumgartner, Jeroen J. Bax, Héctor Bueno, Veronica Dean, Christi Deaton, Çetin Erol, Roberto Ferrari, David Hasdai, Arno W. Hoes, Juhani Knuuti, Philippe Kolh, Patrizio Lancellotti, Aleš Linhart, Petros Nihoyannopoulos, Massimo F Piepoli, Piotr Ponikowski, Juan Tamargo, Michal Tendera, Adam Torbicki, William Wijns, Stephan Windecker, Denis Clement, Thierry C. Gillebert, Enrico Agabiti Rosei, Stefan D. Anker, Johann Bauersachs, Jana Brguljan Hitij, Mark J. Caulfield, Marc De Buyzere, Sabina De Geest, Geneviève Derumeaux, Serap Erdine, Csaba Farsang, Christian Funck-Brentano, Vjekoslav Gerc, Giuseppe Germanò, Stephan Gielen, Herman Haller, Jens Jordan, Thomas Kahan, Michel Komajda, Dragan Lovic, Heiko Mahrholdt, Jan Östergren, Gianfranco Parati, Joep Perk, Jorge Polónia, Bogdan A. Popescu, Zeljko Reiner, Lars Rydén, Yuriy Sirenko, Alice Stanton, Harry A.J. Struijker-Boudier, Charalambos Vlachopoulos, Massimo Volpe, David A. Wood 
2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)

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05 Feb 2014-JAMA
Paul A. James, Suzanne Oparil, Barry L. Carter, William C. Cushman, Cheryl Dennison-Himmelfarb, Joel Handler, Daniel T. Lackland, Michael L. LeFevre, Thomas D. MacKenzie, Olugbenga Ogedegbe, Sidney C. Smith, Laura P. Svetkey, Sandra J. Taler, Raymond R. Townsend, Jackson T. Wright, Andrew S. Narva, Eduardo Ortiz 
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report.

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21 May 2003-JAMA
Aram V. Chobanian, George L. Bakris, Henry R. Black, William C. Cushman, Lee A. Green, Joseph L. Izzo, Daniel W. Jones, Barry J. Materson, Suzanne Oparil, Jackson T. Wright, Edward J. Roccella 
Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies.

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14 Dec 2002-The Lancet
Sarah Lewington, Robert Clarke, Nawab Qizilbash, Richard Peto, Rory Collins 
Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure

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01 Dec 2003-Hypertension
Aram V. Chobanian, George L. Bakris, Henry R. Black, William C. Cushman, Lee A. Green, Joseph L. Izzo, Daniel W. Jones, Barry J. Materson, Suzanne Oparil, Jackson T. Wright, Edward J. Roccella 
Frequently Asked Questions (12)
Q1. What have the authors contributed in "2018 practice guidelines for the management of arterial hypertension of the european society of hypertension (esh) and the european society of cardiology (esc) esh/esc task force for the management of arterial hypertension" ?

The European Society of Cardiology/European Society of Hypertension ( ESC/ESH ) guidelines for the management of arterial hypertension are designed for adults with hypertension, i.e. aged ≥18 years this paper. 

Physician inertia (inadequate up-titration of treatment, especially from monotherapy) and poor patient adherence to treatment (especially when based on multiple pills) are now recognised as the major factors contributing to poor BP control. 

Auscultatory or oscillometric semiautomatic or automatic sphygmomanometers are the preferred method for measuring BP in the doctor’s office. 

It is increasingly recognised that biological rather than chronological age, as well as consideration of frailty and independence, are important determinants of the tolerability of and likely benefit from BP-lowering medications. 

There is growing evidence that poor adherence to treatment − in addition to physician inertia (i.e. lack of therapeutic action when the patient’s BP is uncontrolled) − is the most important cause of poor BP control. 

SPC therapy is now the preferred strategy for initial two-drug combination treatment of hypertension and for three-drug combination therapy when required. 

The authors now recommend that patients with low−moderate risk grade 1 hypertension (office BP 140–159/90–99), even if they do not have HMOD,should now receive drug treatment if their BP is not controlled after a period of lifestyle intervention alone. 

The evidence strongly suggests that lowering office SBP to < 140 mmHg is beneficial for all patient groups, including independent older patients. 

The purpose of the review and update of these guidelines was to evaluate and incorporate new evidence into the guideline recommendations. 

For hypertensive patients at moderate CVD risk or higher, or those with established CVD, BP lowering alone will not optimally reduce their risk. 

The level to which BP should be lowered with drug treatment will depend on the patients’ age, comorbidities and tolerability of treatment. 

The rate and magnitude of increase in BP may be at least as important as the absolute level of BP in determining the magnitude of organ injuryAfter the initiation of antihypertensive drug therapy, it is important to review the patient at least once within the first 2 months to evaluate the effects on BP and assess possible side-effects until BP is under control.