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<p>Arterial hypertension remains one of the most frequent risk factors for morbidity and mortality worldwide. Continuous improvement in the clinical management of arterial hypertension is therefore necessary for effective cardiovascular prevention. In this context the 2024 guidelines of the European Society of Cardiology (ESC) on the management of elevated blood pressure and hypertension are of particular importance. In the new guidelines the importance of home-based blood pressure measurement under standardized conditions for diagnostics and treatment control has been further strengthened. A&#xa0;new, stricter blood pressure classification has been introduced, with new categories for “non-elevated” blood pressure (&lt; 120/70 mm Hg) and “elevated” blood pressure (120/70–139/89 mm Hg). In the “elevated” blood pressure category, treatment decisions should be based on the overall cardiovascular risk. New recommendations for lifestyle interventions now include recommendations for dynamic or isometric resistance training, potassium intake and sugar reduction in addition to aerobic exercise training. Drug treatment should preferably be carried out in combination therapy as a&#xa0;single pill combination. The use of low-dose double or triple combinations is recommended at the start of treatment. Renal denervation can be considered to lower blood pressure in patients with treatment resistant hypertension if the treatment is carried out in a&#xa0;specialized center. These comments provide a compact summary and critical examination of the main innovations in the guidelines and discuss their practical implementation in the context of the German healthcare system.</p>

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DGK-Kommentar zu den Leitlinien der ESC (2024) für die Behandlung von erhöhtem Blutdruck und Hypertonie

  • 期刊论文

  • 发表日期：

    2025年4月30日

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  • Ulrich Kintscher,
  • Marcel Halbach,
  • Susanne Berrisch-Rahmel,
  • Sabine Genth-Zotz,
  • Joachim Weil,
  • Felix Mahfoud

摘要

Arterial hypertension remains one of the most frequent risk factors for morbidity and mortality worldwide. Continuous improvement in the clinical management of arterial hypertension is therefore necessary for effective cardiovascular prevention. In this context the 2024 guidelines of the European Society of Cardiology (ESC) on the management of elevated blood pressure and hypertension are of particular importance. In the new guidelines the importance of home-based blood pressure measurement under standardized conditions for diagnostics and treatment control has been further strengthened. A new, stricter blood pressure classification has been introduced, with new categories for “non-elevated” blood pressure (< 120/70 mm Hg) and “elevated” blood pressure (120/70–139/89 mm Hg). In the “elevated” blood pressure category, treatment decisions should be based on the overall cardiovascular risk. New recommendations for lifestyle interventions now include recommendations for dynamic or isometric resistance training, potassium intake and sugar reduction in addition to aerobic exercise training. Drug treatment should preferably be carried out in combination therapy as a single pill combination. The use of low-dose double or triple combinations is recommended at the start of treatment. Renal denervation can be considered to lower blood pressure in patients with treatment resistant hypertension if the treatment is carried out in a specialized center. These comments provide a compact summary and critical examination of the main innovations in the guidelines and discuss their practical implementation in the context of the German healthcare system.