Vnitr Lek 2025, 71(2):86-92 | DOI: 10.36290/vnl.2025.016

What do the new ESC 2024 guidelines for the treatment of hypertension offer and how do they differ from ESH 2023?

Libor Jelínek^{1, 2}, Zdeněk Ramík^{1, 2, 3, 4}, Radek Adámek^{1, 2}, Jan Václavík^{1, 2, 3, 4}

¹ Klinika tělovýchovného lékařství a kardiovaskulární rehabilitace, Fakultní nemocnice Olomouc

² Lékařská fakulta, Univerzita Palackého, Olomouc

³ Interní a kardiologická klinika, Fakultní nemocnice Ostrava

⁴ Lékařská fakulta, Ostravská univerzita, Ostrava

Although the prevalence of arterial hypertension is increasing worldwide, the percentage of patients with controlled hypertension is also increasing. In diagnosing and treating arterial hypertension, doctors can rely on the European Society of Cardiology (ESC) 2024 and European Society of Hypertension (ESH) 2023 guidelines. Both sets of guidelines emphasize existing and add new recommendations. Values in the range of 120-139/70-89 mm Hg are now considered elevated blood pressure by ESC. In the diagnosis of hypertension, there is consensus on the emphasis on out-of-hospital blood pressure measurement. Initiation of pharmacotherapy is indicated in all patients with hypertension along with non-pharmacological measures. In most patients with hypertension, except for the old and frail, pharmacotherapy is initiated with a fixed two-combination at lower doses, the second step being a three-combination at lower doses. In patients with elevated blood pressure and high cardiovascular risk, pharmacotherapy is also newly recommended. Target values for systolic blood pressure are in the range 120-129 mm Hg, diastolic < 80 mm Hg. Furthermore, both sets of recommendations offer answers to many specific situations related to specific patient groups such as younger patients, older patients, pregnant women, patients with renal insufficiency, etc.

Keywords: arterial hypertension, guidelines, European Society of Hypertension, European Society of Cardiology.

Accepted: March 18, 2025; Published: March 27, 2025  Show citation