Key Messages of 2024 ESC Guidelines for High BP

The number of individuals with high blood pressure (BP) is increasing worldwide. The trajectory of BP control appears to be worsening in North America, some European countries, and elsewhere around the world. The risk for cardiovascular diseases (CVD) attributable to BP is on a continuous log-linear exposure variable scale, not a binary scale of normal BP vs. high BP. A new BP category called ‘elevated BP’ is introduced, as BP-lowering drugs can reduce CVD risk even among individuals not traditionally classified as high BP. Elevated BP is defined as an office systolic BP of 120–139 mmHg or diastolic BP of 70–89 mmHg. High BP remains defined as office BP of ≥140/90 mmHg. High BP in women is under-studied. High BP-mediated organ damage suggests long-standing or severe high BP and is associated with increased CVD risk. Absolute CVD risk must be considered when assessing and managing elevated BP. The rates of diagnosis, treatment, and control of high BP (and elevated BP) remain suboptimal. One of the most important changes in the 2024 Guidelines is the focus on evidence related to CVD outcomes of BP-lowering interventions rather than BP lowering alone. The on-treatment BP target is 120–129/70–79 mmHg for all adults, provided this treatment is well tolerated with important exceptions. Source: https://academic.oup.com/eurheartj/