Updating approaches to patient management in the light of new European guidelines on arterial hypertension: analytical review
- Authors: Larina V.N.1, Vartanyan E.A.1, Fedorova E.V.1, Mikhaylusova M.P.1, Sayno O.V.1, Mironova T.N.1
-
Affiliations:
- Pirogov Russian National Research Medical University
- Issue: Vol 14, No 3 (2023)
- Pages: 187-196
- Section: Reviews
- URL: https://journals.rcsi.science/2221-7185/article/view/146509
- DOI: https://doi.org/10.17816/CS567844
- ID: 146509
Cite item
Full Text
Abstract
Data from epidemiological studies show a high prevalence of cardiovascular diseases, including arterial hypertension (AH) and the risk of complications, with changes in AH control and treatment techniques. The review article summarizes the main directions of the new European guidelines on hypertension, which help implement different patient groups in outpatient practice. Secondary risk factors for cardiovascular disease are revised in the new clinical guidelines. The recommendation outlines a diagnostic and therapeutic approach for resistant arterial hypertension, its associated phenotypes, and night-time hypertension. The use and position of renal denervation for antihypertensive treatment have been updated compared with previous recommendations. The new European clinical guidelines reflect a differentiated approach to target indicators of ambulatory blood pressure in different age groups, with functional levels of aging, comorbidity, and AH phenotypes, which is of great clinical importance for a primary care physician and can significantly reduce the risk of heart disease vascular complications.
Full Text
##article.viewOnOriginalSite##About the authors
Vera N. Larina
Pirogov Russian National Research Medical University
Author for correspondence.
Email: larinav@mail.ru
ORCID iD: 0000-0001-7825-5597
SPIN-code: 3674-9620
MD, Dr. Sci. (Med.), Professor
Russian Federation, MoscowElena A. Vartanyan
Pirogov Russian National Research Medical University
Email: mediportmail@gmail.com
ORCID iD: 0000-0002-7714-0832
SPIN-code: 1367-0097
MD, Cand. Sci. (Med.), associate professor
Russian Federation, MoscowEkaterina V. Fedorova
Pirogov Russian National Research Medical University
Email: evfedorova91@mail.ru
ORCID iD: 0000-0002-7623-7376
SPIN-code: 4014-4245
MD, Cand. Sci. (Med.), assistant
Russian Federation, MoscowMarina P. Mikhaylusova
Pirogov Russian National Research Medical University
Email: mikhailusova@yandex.ru
ORCID iD: 0000-0003-0271-6726
SPIN-code: 3428-4959
MD, Cand. Sci. (Med.), associate professor
Russian Federation, MoscowOlga V. Sayno
Pirogov Russian National Research Medical University
Email: OlgaSayno33@gmail.com
ORCID iD: 0000-0002-1841-5066
SPIN-code: 6168-7137
MD, Cand. Sci. (Med.), associate professor
Russian Federation, MoscowTatiyana N. Mironova
Pirogov Russian National Research Medical University
Email: mironova.tanya.90@yandex.ru
ORCID iD: 0000-0002-6430-7111
SPIN-code: 1089-3342
MD, Cand. Sci. (Med.), assistant
Russian Federation, MoscowReferences
- NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021;398(10304):957–980. doi: 10.1016/S0140-6736(21)01330-1
- Zhou B, Perel P, Mensah GA, Ezzati M. Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nat Rev Cardiol. 2021;18(11):785–802. doi: 10.1038/s41569-021-00559-8
- Balanova YuA, Shalnova SA, Kutsenko VA, et al. Contribution of hypertension and other risk factors to survival and mortality in the Russian population. Cardiovascular Therapy and Prevention. 2021;20(5):3003. (In Russ). doi: 10.15829/1728-8800-2021-3003
- Mancia G, Kreutz Co-Chair R, Brunström M, et al. 2023 ESH Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the European Renal Association (ERA) and the International Society of Hypertension (ISH). J Hypertens. 2023. Epub ahead of print. doi: 10.1097/HJH.0000000000003480
- Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018;39(33):3021–3104. doi: 10.1093/eurheartj/ehy339
- Unger T, Borghi C, Charchar F, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020;75(6):1334–1357. doi: 10.1161/HYPERTENSIONAHA.120.15026
- Brunstrom M, Carlberg B. Association of blood pressure lowering with mortality and cardiovascular disease across blood pressure levels: a systematic review and meta-analysis. JAMA Intern Med. 2018;178(1):28–36. doi: 10.1001/jamainternmed.2017.6015
- Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering treatment on outcome incidence. 12. Effects in individuals with highnormal and normal blood pressure: overview and meta-analyses of randomized trials. J Hypertens. 2017;35(11):2150–2160. doi: 10.1097/HJH.0000000000001547
- Xu W, Goldberg SI, Shubina M, Turchin A. Optimal systolic blood pressure target, time to intensification, and time to follow-up in treatment of hypertension: population based retrospective cohort study. BMJ. 2015;350:h158. doi: 10.1136/bmj.h158
- Parati G, Kjeldsen S, Coca A, et al. Adherence to single-pill versus free-equivalent combination therapy in hypertension: a systematic review and meta-analysis. Hypertension. 2021;77(2):692–705. doi: 10.1161/HYPERTENSIONAHA.120.15781
- Egan BM, Bandyopadhyay D, Shaftman SR, et al. Initial monotherapy and combination therapy and hypertension control the first year. Hypertension. 2012;59(6):1124–1131. doi: 10.1161/HYPERTENSIONAHA.112.194167
- Boytsov SA, Karpov YuA, Logunova NA, et al. Ways to increase adherence to antihypertensive therapy. Russian Journal of Cardiology. 2022;27(9):5202. (In Russ). doi: 10.15829/1560-4071-2022-5202
- Mancia G, Rea F, Corrao G, Grassi G. Two-drug combinations as first-step antihypertensive treatment. Circ Res. 2019;124(7):1113–1123. doi: 10.1161/CIRCRESAHA.118.313294
- Egan BM, Kjeldsen SE, Narkiewicz K, et al. Single-pill combinations, hypertension control and clinical outcomes: potential, pitfalls and solutions. Blood Press. 2022;31(1):164–168. doi: 10.1080/08037051.2022.2095254
- Gradman AH, Parise H, Lefebvre P, et al. Initial combination therapy reduces the risk of cardiovascular events in hypertensive patients: a matched cohort study. Hypertension. 2013;61(2):309–318. doi: 10.1161/HYPERTENSIONAHA.112.201566
- De Nicola L, Gabbai FB, Agarwal R, et al. Prevalence and prognostic role of resistant hypertension in chronic kidney disease patients. J Am Coll Cardiol. 2013;61(24):2461–2467. doi: 10.1016/j.jacc.2012.12.061
- Salazar MR, Espeche WG, Balbin E, et al. Prevalence of isolated nocturnal hypertension according to 2018 European Society of Cardiology and European Society of Hypertension office blood pressure categories. J Hypertens. 2020;38(3):434–440. doi: 10.1097/HJH.0000000000002278
- Cuspidi C, Paoletti F, Tadic M, et al. Nocturnal blood pressure: the dark side of white-coat hypertension. J Hypertens. 2020;38(12):2404–2408. doi: 10.1097/HJH.0000000000002541
- Cuspidi C, Sala C, Tadic M, et al. Nocturnal hypertension and subclinical cardiac and carotid damage: an updated review and meta-analysis of echocardiographic studies. J Clin Hypertens (Greenwich). 2016;18(9):913–920. doi: 10.1111/jch.12790
- Carey RM, Sakhuja S, Calhoun DA, et al. Prevalence of apparent treatment-resistant hypertension in the United States. Hypertension. 2019;73(2):424–431. doi: 10.1161/HYPERTENSIONAHA.118.12191
- Egan BM, Zhao Y, Li J, et al. Prevalence of optimal treatment regimens in patients with apparent treatment resistant hypertension based on office blood pressure in a community-based practice network. Hypertension. 2013;62(4):691–697. doi: 10.1161/HYPERTENSIONAHA.113.01448
- Kario K, Hoshide S, Narita K, et al. Cardiovascular prognosis in drug-resistant hypertension stratified by 24-hour ambulatory blood pressure: the JAMP Study. Hypertension. 2021;78(6):1781–1790. doi: 10.1161/HYPERTENSIONAHA.121.18198
- Li S, Schwartz JE, Shimbo D, et al. Booth JN 3rd, et al. Estimated prevalence of masked asleep hypertension in US adults. JAMA Cardiol. 2021;6(5):568–573. doi: 10.1001/jamacardio.2020.5212
- Ruilope LM, Rodriguez-Sanchez E, Navarro-Garcia JA, et al. Resistant hypertension: new insights and therapeutic perspectives. Eur Heart J Cardiovasc Pharmacother. 2020;6(3):188–193. doi: 10.1093/ehjcvp/pvz057
- Fujiwara T, Hoshide S, Kanegae H, Kario K. Cardiovascular event risks associated with masked nocturnal hypertension defined by home blood pressure monitoring in the J-HOP Nocturnal Blood Pressure Study. Hypertension. 2020;76(1):259–266. doi: 10.1161/HYPERTENSIONAHA.120.14790
- Schmieder RE. Renal denervation in patients with chronic kidney disease: current evidence and future perspectives. Nephrol Dial Transplant. 2022;38(5):1089–1096. doi: 10.1093/ndt/gfac189
- Grassi G, Seravalle G, Brambilla G, et al. Blood pressure responses to renal denervation precede and are independent of the sympathetic and baroreflex effects. Hypertension. 2015;65(6):1209–1216. doi: 10.1161/HYPERTENSIONAHA.114.04823
- Biffi A, Dell’Oro R, Quarti-Trevano F, et al. Effects of renal denervation on sympathetic nerve traffic and correlates in drug-resistant and uncontrolled hypertension: a systematic review and meta-analysis. Hypertension. 2023;80(3):659–667. doi: 10.1161/HYPERTENSIONAHA.122.20503
- Schmieder RE, Mahfoud F, Mancia G, et al. Clinical Event Reductions in High-Risk Patients After Renal Denervation Projected from the Global SYMPLICITY Registry. Eur Heart J Qual Care Clin Outcomes. 2023;9(6):575–582. doi: 10.1093/ehjqcco/qcac056