Page 7 - GUIAS ESC ESH 2018
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ESC/ESH Guidelines                                                                                 7




           2.1 What is new and what has changed in the 2018 ESC/ESH Arterial Hypertension
           Guidelines?








              Changes in recommendations
              2013                                          2018
              Diagnosis                                     Diagnosis

              Office BP is recommended for screening and diagnosis of  It is recommended to base the diagnosis of hypertension on:
              hypertension.                                 • Repeated office BP measurements; or
                                                            • Out-of-office BP measurement with ABPM and/or HBPM if logistically
                                                              and economically feasible.
              Treatment thresholds                          Treatment thresholds
              Highnormal BP (130–139/85–89 mmHg): Unless the necessary Highnormal BP (130–139/85–89 mmHg): Drug treatment may be
              evidence is obtained, it is not recommended to initiate  considered when CV risk is very high due to established CVD, especially
              antihypertensive drug therapy at high–normal BP.  CAD.
              Treatment thresholds                          Treatment thresholds
              Treatment of low-risk grade 1 hypertension:   Treatment of low-risk grade 1 hypertension:
              Initiation of antihypertensive drug treatment should also be  In patients with grade 1 hypertension at low–moderate-risk and without
              considered in grade 1 hypertensive patients at low–moderate-risk,  evidence of HMOD, BP-lowering drug treatment is recommended if the
              when BP is within this range at several repeated visits or elevated by  patient remains hypertensive after a period of lifestyle intervention.
              ambulatory BP criteria, and remains within this range despite a
              reasonable period of time with lifestyle measures.
              Treatment thresholds                          Treatment thresholds
              Older patients                                Older patients
              Antihypertensive drug treatment may be considered in the elderly  BP-lowering drug treatment and lifestyle intervention is recommended in
              (at least when younger than 80 years) when SBP is in the  fit older patients (>65 years but not >80 years) when SBP is in the
              140–159 mmHg range, provided that antihypertensive treatment is  grade 1 range (140–159 mmHg), provided that treatment is well tolerated.
              well tolerated.
              BP treatment targets                          BP treatment targets
              An SBP goal of <140 mmHg is recommended.      • It is recommended that the first objective of treatment should be to
                                                              lower BP to <140/90 mmHg in all patients and, provided that the
                                                              treatment is well tolerated, treated BP values should be targeted to
                                                              130/80 mmHg or lower in most patients.
                                                            • In patients <65 years it is recommended that SBP should be lowered
                                                              to a BP range of 120–129 mmHg in most patients.
                                                                                                       Continued




















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