Editors’ commentary on the 2023 ESH management of arterial hypertension guidelines

Whelton, P. K., Flack, J. M., Jennings, G. L. R., Schutte, A. E., Wang, J.-G. and Touyz, R. M. (2023) Editors’ commentary on the 2023 ESH management of arterial hypertension guidelines. Hypertension, 80(9), pp. 1795-1799. (doi: 10.1161/HYPERTENSIONAHA.123.21592) (PMID:37354199)

Abstract

Clinical practice guidelines are ideally suited to the provision of advice on the prevention, diagnosis, evaluation, and management of high blood pressure (BP). The recently published European Society of Hypertension (ESH) 2023 ESH Guidelines for the management of arterial hypertension is the latest in a long series of high BP clinical practice guidelines. It closely resembles the 2018 European Society of Cardiology/ESH guidelines, with incremental rather than major changes. Although the ESH guidelines are primarily written for European clinicians and public health workers, there is a high degree of concordance between its recommendations and those in the other major BP guidelines. Despite the large number of national and international BP guidelines around the world, general population surveys demonstrate that BP guidelines are not being well implemented in any part of the world. The level of BP, which is the basis for diagnosis and management, continues to be poorly measured in routine clinical practice and control of hypertension remains sub-optimal, even to a conservative blood pressure target such as a systolic/diastolic BP <140/90 mm Hg. BP guidelines need to focus much more on implementation of recommendations for accurate diagnosis and strategies for improved control in those being treated for hypertension. An evolving body of implementation science can assist in meeting this goal. Given the enormous health, social, and financial burden of high BP better diagnosis and management should be an imperative for clinicians, government, and others responsible for the provision of healthcare services. Hopefully, the 2023 ESH will help enable this.

• Item Type: Articles
• Additional Information: Funding: P.K. Whelton was supported by a Center of Excellence for Clinical, Translational and Implementation Research in Cardiometabolic Diseases (COBRE) at Tulane University from the National Institute of General Medical Sciences, National Institutes of Health (P20GM109036). A. Schutte was supported by a Leadership Investigator Grant from the National Health and Medical Research Council of Australia (ID 2017504).
• Keywords: Financial stress, goals, hypertension, cardiology, government.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Touyz, Professor Rhian
• Authors: Whelton, P. K., Flack, J. M., Jennings, G. L. R., Schutte, A. E., Wang, J.-G., and Touyz, R. M.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Hypertension
• Publisher: American Heart Association
• ISSN: 0194-911X
• ISSN (Online): 1524-4563
• Published Online: 24 June 2023
• Copyright Holders: Copyright © 2023 American Heart Association, Inc.
• First Published: First published in Hypertension 80(9):1795-1799
• Publisher Policy: Reproduced in accordance with the publisher copyright policy