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. 2022 Sep 14;43(35):3302-3311.
doi: 10.1093/eurheartj/ehac432.

Harmonization of the American College of Cardiology/American Heart Association and European Society of Cardiology/European Society of Hypertension Blood Pressure/Hypertension Guidelines

Paul K Whelton  1   2 , Robert M Carey  3 , Giuseppe Mancia  4 , Reinhold Kreutz  5 , Joshua D Bundy  1 , Bryan Williams  6   7
Affiliations

Harmonization of the American College of Cardiology/American Heart Association and European Society of Cardiology/European Society of Hypertension Blood Pressure/Hypertension Guidelines

Paul K Whelton et al. Eur Heart J. .

Abstract

The 2017 American College of Cardiology/American Heart Association and 2018 European Society of Cardiology/European Society of Hypertension clinical practice guidelines for management of high blood pressure/hypertension are influential documents. Both guidelines are comprehensive, were developed using rigorous processes, and underwent extensive peer review. The most notable difference between the 2 guidelines is the blood pressure cut points recommended for the diagnosis of hypertension. There are also differences in the timing and intensity of treatment, with the American College of Cardiology/American Heart Association guideline recommending a somewhat more intensive approach. Overall, there is substantial concordance in the recommendations provided by the 2 guideline-writing committees, with greater congruity between them than their predecessors. Additional harmonization of future guidelines would help to underscore the commonality of their core recommendations and could serve to catalyze changes in practice that would lead to improved prevention, awareness, treatment, and control of hypertension, worldwide.

Keywords: antihypertensive agents; blood pressure; cardiovascular diseases; hypertension; life style; practice guideline; public health.

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Figures

Figure 1
Figure 1
Categories of cardiovascular disease risk in the 2018 ESC/ESH hypertension guideline. BP indicates blood pressure; CKD, chronic kidney disease; CVD, cardiovascular disease; eGFR, estimated glomerular filtration rate; ESC, European Society of Cardiology; ESH, European Society of Hypertension; HMOD, hypertension-mediated organ damage; LVH, left ventricular hypertrophy; PAD, peripheral artery disease; SCORE, Systematic Coronary Risk Evaluation; and TIA, transient ischemic attack. Reprinted from Williams et al with permission. Copyright © 2018, Oxford University Press
Figure 2
Figure 2
Blood pressure thresholds for initiation of blood pressure–lowering therapies in the 2017 ACC/AHA and 2018 ESC/ESH blood pressure guidelines. ACC indicates American College of Cardiology; AHA, American Heart Association; ASCVD, atherosclerotic cardiovascular disease; BP, blood pressure; CAD, coronary heart disease; CVD, cardiovascular disease; ESC, European Society of Cardiology; ESH, European Society of Hypertension; and HMOD, hypertension-mediated organ damage. Adapted from Whelton et al with permission. Copyright © 2018, Elsevier; and Williams et al with permission. Copyright © 2018, Oxford University Press.
See this image and copyright information in PMC

References

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