Editorials
Vol. 19 No. 2 (2025)
When should antihypertensive drug treatment be started? Discrepancies between the 2023 European Society of Hypertension and the 2024 European Society of Cardiology guidelines
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 16 April 2025
1000
Views
318
Downloads
0
HTML
Authors
One of the most important recommendations from the guidelines on hypertension is to decide when to lower blood pressure through antihypertensive treatment...
Downloads
Download data is not yet available.
Citations
Mancia G, Kreutz R, Brunström M, et al. 2023 ESH guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens 2023;41:1874-2071. Erratum in: J Hypertens 2024;42:194. DOI: https://doi.org/10.1097/HJH.0000000000003621
McEvoy JW, McCarthy CP, Bruno RM, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J 2024;45:3912-4018. Erratum in: Eur Heart J 2025; doi: 10.1093/eurheartj/ehaf031. DOI: https://doi.org/10.1093/eurheartj/ehaf031
Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering treatment on outcome incidence. 12. Effects in individuals with high-normal and normal blood pressure: overview and meta-analyses of randomized trials. J Hypertens 2017;35:2150-60. DOI: https://doi.org/10.1097/HJH.0000000000001547
Williamson JD, Supiano MA, Applegate WB, et al. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥75 years: a randomized clinical trial. JAMA 2016;315:2673-82. DOI: https://doi.org/10.1001/jama.2016.7050
Rea F, Cantarutti A, Merlino L, et al. Antihypertensive treatment in elderly frail patients: evidence from a large Italian database. Hypertension 2020;76:442-9. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.120.14683
Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J 2018;39:3021-104. Erratum: Eur Heart J 2019;40:475. DOI: https://doi.org/10.1093/eurheartj/ehy686
Beckett NS, Peters R, Fletcher AE, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008;358:1887-98. DOI: https://doi.org/10.1056/NEJMoa0801369
Blood Pressure Lowering Treatment Trialists' Collaboration. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. Lancet 2021;397:1625-36.
Kreutz R, Brunström M, Thomopoulos C, et al. Do recent meta-analyses truly prove that treatment with blood pressure-lowering drugs is beneficial at any blood pressure value, no matter how low? A critical review. J Hypertens 2022;40:839-46. DOI: https://doi.org/10.1097/HJH.0000000000003056
Lonn EM, Bosch J, López-Jaramillo P, et al. Blood-pressure lowering in intermediate-risk persons without cardiovascular disease. N Engl J Med 2016;374:2009-20. DOI: https://doi.org/10.1056/NEJMoa1600175
Bosch J, Lonn EM, Jung H, et al. Lowering cholesterol, blood pressure, or both to prevent cardiovascular events: results of 8.7 years of follow-up of Heart Outcomes Evaluation Prevention (HOPE)-3 study participants. Eur Heart J 2021;42:2995-3007. DOI: https://doi.org/10.1093/eurheartj/ehab225
SPRINT Research Group, Wright JT Jr, Williamson JD, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 2015;373:2103-16. DOI: https://doi.org/10.1056/NEJMoa1511939
Dahlöf B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002;359:995-1003. DOI: https://doi.org/10.1016/S0140-6736(02)08089-3
Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering treatment in hypertension: 9. Discontinuations for adverse events attributed to different classes of antihypertensive drugs: meta-analyses of randomized trials. J Hypertens 2016;34:1921-32. DOI: https://doi.org/10.1097/HJH.0000000000001052
Hirakawa Y, Arima H, Webster R, et al. Risks associated with permanent discontinuation of blood pressure-lowering medications in patients with type 2 diabetes. J Hypertens 2016;34:781-7. DOI: https://doi.org/10.1097/HJH.0000000000000841
How to Cite
When should antihypertensive drug treatment be started? Discrepancies between the 2023 European Society of Hypertension and the 2024 European Society of Cardiology guidelines. (2025). Italian Journal of Medicine, 19(2). https://doi.org/10.4081/itjm.2025.1981
Copyright (c) 2025 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.