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New European Hypertension Guidelines Released:Goal Is Less Than 140 mm Hg for AllMichael O'Riordan

Jun 15, 2013MILAN, Italy The European Society of Hypertension (ESH) and the European Society of Cardiology(ESC) published new guidelines today for the management of hypertension, simplifying treatment decisions forphysicians with the recommendation that all patients be treated to 180 systolic or >110mm Hg diastolic). The presence or absence of other cardiovascular risk factors or organ damage/disease
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should be then factored into treatment decisions for the management of blood pressure (a full risk-assessmentalgorithm is included in the guidelines).

Fagard said the new guidelines also make a host of lifestyle recommendations for lowering blood pressure. Hesaid they are recommending salt intake of approximately 5 to 6 g per day, in contrast with a typical intake of 9to 12 g per day. A reduction to 5 g per day can decrease systolic blood pressure about 1 to 2 mm Hg innormotensive individuals and 4 to 5 mm Hg in hypertensive patients, he said.

While the optimal body-mass index (BMI) is not known, the guidelines recommend getting BMIs down to 25kg/m2 and reducing waist circumferences to


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As for thecancer signal that has recently been attached to ARBs, the committee unequivocally stated that such a riskhas been disproven. The USFood and Drug Administrationand a review by theEuropean Medicines Agency

have both concluded that no such a cancer risk exists, said the panelists during the press conference.

Resistant Hypertension

One interesting aspect of the new guidelines is that renal denervation, a quickly growing and frequently hyped

treatment within the cardiology community, is simply labeled as a "promising" therapy in the treatment ofresistant hypertension.

The committee said that renal denervation is in need of additional data from long-term comparison trials toestablish safety and efficacy against the best possible drug regimens. Moreover, there is also a need todetermine whether the reductions in blood pressure achieved with renal denervation translate into reductions incardiovascular morbidity and mortality, something that has never been proven.

Mancia reports speaker fees, honoraria, consultancy payments, and advisory board fees from Abbott,AstraZeneca, Boehringer Ingelheim, Novartis, Servier, Sanofi, Menarini, Takeda Pharmaceuticals, Bayer,Recordati, Daiichi Sankyo, and Medtronic. Redon reports speaker fees, honoraria, consultancy payments, andadvisory board fees from Boehringer Ingelheim, Novartis, Menarini, Merck, AstraZeneca, Bristol-Myers Squibb,and Daiichi-Sankyo. Fagard reports receiving honorarium from Servier. Disclosures for other members of thewriting committee are availablehere.

References

1. Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterialhypertension. Eur Heart J2013; DOI: 10.1093/eurheartj/eht.151. Availablehere.

Heartwire 2013 Medscape, LLC

Cite this article: New European Hypertension Guidelines Released: Goal Is Less Than 140 mm Hg forAll. Medscape. Jun 15, 2013.
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