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Hypertension: Stricter hypertension guidelines provided


New European guidelines for high blood pressure

Hypertension is considered a widespread disease, especially in the western world. In Germany alone, around 20 to 30 million people are affected. But how high can the blood pressure values ​​be to still be considered healthy? The European professional associations have now presented new guidelines. The experts define high blood pressure differently from medical professionals in the United States.

Every third German citizen affected

According to health experts, about one in three Germans suffers from high blood pressure or hypertension, as the silent suffering is called by doctors. Until recently, hypertension was defined by a systolic blood pressure of over 140 mmHg or a diastolic blood pressure of more than 90 mmHg. But lately there have been increasing voices saying that 120 instead of 140 should be the new blood pressure target. US specialist societies lowered their blood pressure guidelines a few months ago (new 130/80 mmHg). Since then, up to 40 percent more are considered hypertension patients. The European professional associations do not define hypertension in the new guidelines like their US colleagues.

New European guidelines for the treatment of high blood pressure

As the German Hypertension League (DHL) reports, the new European guidelines for the treatment of high blood pressure were presented for the first time at the congress of the “European Society of Hypertension” (ESH).

According to the information, the new guidelines still adhere to the existing disease definition of ≥140 / 90 mm Hg, but recommend striving to lower the normal range (<130/80 mm Hg).

"The US guidelines already define hypertension from values ​​≥130 / 80 mm Hg," explained Professor Dr. med. Peter Trenkwalder, Deputy CEO of DHL.

The limit was lowered in 2017 in part in response to the SPRINT study.

Differentiation between optimal and highly normal blood pressure range

“The European guidelines commission, however, did not see sufficient evidence for such a recommendation. The new guideline also stipulates that the majority of hypertensives should only be treated with medication from a blood pressure of 140/90 mm Hg ”, says Dr. Trenkwalder.

According to DHL, like the previous guideline, it differentiates between an optimal blood pressure range (<120/80 mm Hg), a normal (120-129 / 80-84 mm Hg) and a highly normal (130-139 / 85-89 mm Hg).

Only higher values ​​are classified as pathological and should be treated with medication if a lifestyle change, which is already recommended to patients with high normal values, has not shown any success.

Lower blood pressure naturally

In fact, high blood pressure can often be reduced without medication. Especially those who are overweight are usually advised to lose weight.

They should also exercise regularly and refrain from smoking and excessive alcohol consumption. A balanced, healthy diet can also help to lower blood pressure.

It is very important here: salt only in moderation. A high-salt diet can raise blood pressure. No more than four to six grams of salt should be consumed per day.

It should be noted that large quantities of salt are often contained in most finished products.

The menu should generally contain a lot of fruits and vegetables. Garlic, beetroot juices and hawthorn are particularly recommended.

Mediterranean food with olive oil and vegetables is also recommended, as British researchers have shown.

Furthermore, relaxation exercises for stress relief such as yoga or autogenic training can be very effective and positively influence high blood pressure values.

Some home remedies for high blood pressure, such as Kneipp applications, can offer good support.

Modern hypertension therapy should be individualized

But in some cases, a healthier lifestyle is not enough to lower blood pressure enough. Then medication becomes necessary.

According to the President of DHL, Professor Krämer, the general rule is: "Hypertension is a complex clinical picture and modern hypertension therapy should be individualized, the guidelines only set the rough framework."

“The primary goal must be to successfully bring all hypertensives below this value of 140/90 mm Hg, but if possible into the normal range (<130/80 mm Hg). But currently half of all people with high blood pressure are not or not successfully treated, ”said the expert.

The reasons for this lay in a lack of adherence to therapy by the patient and in the fact that the disease still remains unreported.

The new guideline addresses these two problems, which DHL expressly welcomes. On the one hand, she recommends that normotensive adults with optimal blood pressure values ​​below 120/80 mmHg receive a blood pressure screening measurement every five years, and adults with highly normal blood pressure values ​​(130-139 / 85-89 mmHg) at least annually.

In order to strengthen adherence to therapy, she recommends the use of fixed dose combinations ("single pill combinations" = SPC; 2-3 hypotensive substances in a single tablet) - it is known that adherence to therapy decreases, the more different tablets the patients have to take.

Accordingly, there has also been a paradigm shift in therapy: "Drug therapy should now primarily take the form of a 2-fold combination therapy consisting of ACE inhibitors or angiotensin receptor blockers (ARB) and a calcium antagonist or thiazide diuretic; monotherapy has had its day as a first-line therapy" explained Professor Krämer. (ad)

Author and source information

Video: Guidelines for Hypertension Treatment. UPMC (August 2020).