Related Experiment Video
Updated: Jan 9, 2026
Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
Published on: May 3, 2018
Bridging the gap between hypertension guidelines and real-life practice: strategies and technological tools for
Grzegorz Bilo1,2, Sofie Brouwers3,4, Anastasios Kollias5
1Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milan, Italy.
Insights
Global hypertension control remains low despite effective drugs. New guidelines lower blood pressure (BP) targets, increasing treatment challenges. This review explores barriers and solutions for better BP management worldwide.
Area of Science:
- Cardiology
- Public Health
- Implementation Science
Background:
- Hypertension is a primary cardiovascular risk factor globally.
- Low blood pressure (BP) control rates persist despite available treatments.
- Recent European guidelines lower BP treatment thresholds, posing implementation challenges.
Purpose of the Study:
- To review barriers to implementing hypertension guidelines in diverse economic settings.
- To propose solutions for improving hypertension detection, control, and adherence.
- To identify future research directions for enhanced global hypertension management.
Main Methods:
- Narrative review of current hypertension care standards and implementation challenges.
- Analysis of strategies for BP measurement, lifestyle interventions, and treatment adherence.
- Discussion of organizational solutions for long-term patient follow-up.
Main Results:
- Identified significant barriers to guideline implementation across high-, low-, and middle-income countries.
- Highlighted the need for innovative BP monitoring technologies and diverse care settings.
- Emphasized the importance of lifestyle changes, adherence improvement, and structured follow-up.
Conclusions:
- Addressing implementation barriers is crucial for improving global hypertension control.
- Multi-faceted strategies including technological, behavioral, and organizational approaches are needed.
- Future research should focus on effective implementation science for hypertension care standards.
Abstract:
Hypertension is the leading cardiovascular risk factor. However, despite the availability of safe and effective antihypertensive drugs, blood pressure (BP) control rates remain low worldwide. In this context, the recent European hypertension guidelines present an additional challenge by lowering the BP threshold for initiating pharmacological treatment to below 140/90 mmHg for selected high-risk patients and recommending that BP values be lowered to below 130/80 mmHg for most hypertensive patients. In this narrative review, we discuss the barriers to the implementation of guideline-defined standards of care in high-, low-, and middle-income countries and consider some possible solutions to improve this situation. We discuss strategies for detecting hypertension and monitoring its control, including new technologies and settings for BP measurement. Key issues related to the treatment of hypertension at the population level are also addressed, including lifestyle interventions, improving adherence to treatment, and organizational solutions, particularly for long-term follow-up of hypertensive patients. Finally, we identify key areas for future research into the implementation of hypertension care standards and attempt to suggest possible strategies that may be particularly relevant in the future, with the aim of improving global hypertension control rates and reducing the burden of its complications.
Related Concept Videos
01:28Hypertension IV: Drug Therapy and Lifestyle Modifications
01:25Errors occurring during blood pressure monitoring
Several factors...
01:23Hypertension V: Nursing Management
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
01:28Factors affecting Blood pressure
Physiological Factors:
01:10Pre-Procedural Guidelines for Assessing Blood Pressure