New ESC guidelines introduce intensive blood pressure targets and renal denervation recommendations

Updated ESC Guidelines on the management of elevated blood pressure and hypertension include a new elevated blood pressure category, more ambitious and intensive treatment targets, and, for the first time, recommendations on the use of renal denervation to treat various forms of hypertension. The Guidelines have been produced by an international panel of experts that include co-Chairpersons Professor Bill McEvoy of the University of Galway, Ireland, and Professor Rhian Touyz of McGill University, Canada. Elevated blood pressure and hypertension are by far the most common and important risk factors for heart attack and stroke (otherwise known as cardiovascular disease).

As many as 45% of European adults have hypertension. The new guidelines are designed to get more patients to an evidence-based blood pressure treatment target and to increase the eligibility for blood pressure lowering medications to match the best current evidence from clinical trials. The ESC Guidelines also provide numerous pragmatic recommendations to avoid patients becoming symptomatic from overtreatment.

The 2024 Guidelines maintain the existing definition for 'Hypertension' as a BP ≥140/90 mmHg. However, they introduce a new category of 'Elevated BP' which is defined as a BP 120-139/70-89 mmHg. This new 'Elevated BP' category is introduced to facilitate consideration of more intensive blood pressure treatment targets among persons at increased risk for cardiovascular disease.

This new category of eleva.