June 13, 2006, Madrid, Spain – Aspects of the European Society of Hypertension (ESH) Guidelines that could be updated in its next version were reviewed today in a lecture by Professor Giuseppe Mancia, chairperson of the ESH Guidelines Committee, at the 16th European Meeting of Hypertension in Madrid, Spain. The ESH plans to release its updated hypertension guidelines in 2007.
The importance of blood pressure control must be reinforced in the guidelines. The control of blood pressure to <140/90 mmHg or <130/80 mmHg in patients with diabetes must be reached in all patients, because of its clear relation to the reduction of cardiovascular events, Mancia stated. Assessment of the total cardiovascular risk of each patient to determine appropriate treatment for that patient, including the specific blood pressure goal, must be strengthened in the guidelines. Some patients may require aspirin therapy, statin therapy, a more careful assessment of target organ damage, or combination therapy to achieve target blood pressures. Combination therapy is the most successful strategy to reduce blood pressure to goal levels.
Modification of the recommendations for drug treatment for hypertension is another aspect for careful review for the updated guidelines. The most effective treatment for each patient is based on their specific health condition, including risk factors and concomitant disease-their global risk. The traditional agents are not always a wise choice because of their association with more frequent undesired effects, such as new-onset diabetes. Clearer guidance on which drugs are best and when and why would contribute to improved control rates. Currently, only 10-25% of patients with hypertension are controlled to goal blood pressure levels, and these rates must be doubled in the next 5 years.