2013年ESH/ESC动脉高血压管理指南

The Guidelines, which recommend several significant changes to hypertension treatment, are launched* today at the European Society of Hypertension congress in Milan, Italy, with simultaneous online publication in the peer-reviewed journals Journal of Hypertension, the European Heart Journal, and Blood Pressure.

 

First produced in 2003, the original version of the joint ESH/ESC Guidelines for the management of arterial hypertension, became one of the most highly-cited medical papers in the world. The 2013 Guidelines – which replace the 2007 edition – give state of the science recommendations which show how the hypertension landscape has changed, and indicate what needs to be done to reduce mortality and morbidity from high blood pressure and associated conditions. 

 

Hypertension has been described as “the leading global risk for mortality in the world”1.  It continues to affect between 30 and 45% of the European population. The authors of the Guidelines express disappointment that this figure has remained high since the 2003 edition. “We really need to raise awareness of the condition”, said Professor Giuseppe Mancia (Milan, Italy). This is a condition that can be controlled if treated properly.”

 

According to the report, “lifestyle changes are the cornerstone for the prevention of hypertension”, including reduction of salt (to roughly half present levels) and alcohol, as well as maintaining a healthy body weight, regular exercise, and the elimination of smoking. 

 

Additionally, patients and doctors must be aware that once hypertension has developed, it can be treated with drug therapy.  The Guidelines highlight the lack of awareness of the potential problems of hypertension amongst patients, with poor long-term adherence to treatment, and the “inertia” of doctors, who don’t take appropriate action when confronted with patients with uncontrolled blood pressure. 

 

The authors state that “despite overwhelming evidence that hypertension is a major cardiovascular risk, studies show that many are still unaware of the condition, that target blood pressure levels are seldom achieved”.  They also note that there are wide variations in hypertension care in Europe, but that team-based care, with greater nurse involvement, has a better record of success that more standard care.

 

The 2013 Task Force reviewed all relevant data since the last revision (in 2007), with 18 specific diagnostic and therapeutic areas identified as containing significant change.