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International Guidelines for Hypertension: Resemblance, Divergence and Inconsistencies

Junior Justin1, Antoine Fayol1, Rosa-Maria Bruno1,2,3

  • 1Pharmacologie HEGP, APHP (Assistance Publique Hôpitaux de Paris), 75015 Paris, France.

Journal of Clinical Medicine
|April 12, 2022
PubMed

Insights

Global hypertension guidelines show variations in defining normal blood pressure and initial treatment strategies. While most recommend dual therapy, Canadian guidelines suggest monotherapy first, impacting high blood pressure management worldwide.

Area of Science:

  • Cardiology
  • Public Health

Background:

  • High blood pressure (hypertension) is a leading global cause of mortality, affecting approximately 1.5 billion people worldwide.
  • Increasing prevalence necessitates standardized yet adaptable hypertension management strategies.

Purpose of the Study:

  • To compare and contrast key differences in hypertension management among Canadian, American, International, and European guidelines.
  • To highlight variations in blood pressure definitions, measurement techniques, and therapeutic approaches.

Main Methods:

  • Comparative analysis of current international hypertension guidelines (Canadian, AHA, ESC, ISH).
  • Examination of discrepancies in normal blood pressure thresholds and first-line treatment recommendations.

Main Results:

  • Significant differences exist: Canadian guidelines define normal blood pressure as <140/90 mmHg, while AHA and ESC set it at <120/80 mmHg.
  • Treatment initiation varies, with AHA, ISH, and ESC favoring dual therapy, whereas Canadian guidelines propose monotherapy.
  • All guidelines concur on using absolute cardiovascular risk for intervention stratification.

Conclusions:

  • Discrepancies in hypertension guidelines may influence patient care and outcomes globally.
  • Harmonization of guidelines, particularly regarding blood pressure targets and initial therapies, could improve global hypertension control efforts.

Keywords:
agingantihypertensive agentscardiovascular diseasesguidelineshypertensionvascular stiffness

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