We will take you through the “Top Ten Takeaways from the latest Released 2023 European Society of Hypertension Guidelines for Arterial Hypertension” that was released at the 32nd European Meeting on Hypertension & Cardiovascular Protection” held at Allianz, Mico- Milan, Italy.
1. Definition of Hypertension and its threshold for intervention remains unchanged from the 2018 guidelines.
2. The guidelines have included additional clinical conditions as factors that influence Cardiovascular Risk in Hypertension; such as sleep disorders (including OSA), COPD, Gout, Chronic inflammatory diseases, Nonalcoholic fatty liver disease (NASH), Chronic infections (including long COVID-19), Migraine, Depressive syndromes, Erectile dysfunction
3. Environmental exposure to air pollution or noise have been added as to the Factors that influence CV risk in patients with hypertension
4. While Office BP is still the gold Standard for measurement of hypertension, there is Greater emphasis on out-of-office BP measurements including Home BP Measurement and ABPM laid
5. Potassium supplementation in diet has been added as a lifestyle recommendation (
6. There is a more explicit advice for the use of beta blockers as initial antihypertensive drug therapy. Beta Blockers can be used as monotherapy or at any step of combination therapy. These are specific conditions laid down for clinical considerations of Beta Blocker.
7. Initiation of two-drug combination therapy is recommended for most hypertensive patients (Grade IA). Preferred combinations should comprise a RAAS Blocker with a CCB or Thiazide/Thiazide like Diuretics
8. The use of single-pill combination (SPCs) should be preferred at any treatment step i.e., during initiation of therapy with a two-drug combination and at any other step of treatment
9. There is a new simplified approach to antihypertensive drug treatment in patients with heart failure, different for HFpEF and HFrEF with a recommendation for the use of SGLT2-inhibitors in Heart Failure with preserved Ejection Fraction (HFpEF) independently from the presence of diabetes.
10. The use of novel telehealth technologies and virtual care possibilities are recommended to improve hypertension management during follow-up.
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