Download PDF
Int J Angiol 2021; 30(04): 243-248
DOI: 10.1055/s-0041-1732433
Review Article

A “20/20” Match: ACC/AHA 2017 versus ESC/ESH 2018 Guidelines for Management of Hypertension

Akshyaya Pradhan 
1   Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
,
Shweta Vohra 
1   Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
,
Rishi Sethi
1   Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Hypertension, the commonest noncommunicable disease globally, is an important risk factor for cardiovascular disease and renal failure. Theoretically, while it is easy to diagnose and manage by simple measures, practically it has been observed that not only treatment but also diagnosis and its preventive measures are inadequate in developing as well as developed nations. Several guidelines by various international organizations are available to guide clinicians for hypertension management. Though the basic principles of hypertension management are similar in all the guidelines, subtle differences are there. In this article, we compare the two most widely accepted guidelines for hypertension, that is, American College of Cardiology/American Heart Association 2017 Hypertension Guidelines and 2018 European Society of Cardiology and European Society of Hypertension Guidelines on Hypertension. Both the differences and similarities between these two widely followed guidelines are presented.

Keywords

blood pressure targets - risk score - cardiovascular disease - prevention - combination therapy


Publication History

Article published online:
22 November 2021

© 2021. International College of Angiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Chobanian AV, Bakris GL, Black HR. et al; National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289 (19) 2560-2572
    CrossrefPubMedSearch in Google Scholar
  • 2 Mills KT, Bundy JD, Kelly TN. et al. Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 countries. Circulation 2016; 134 (06) 441-450
    CrossrefPubMedSearch in Google Scholar
  • 3 Whelton PK, Carey RM, Aronow WS. et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A Report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol 2018; 71 (19) e127-e248
    CrossrefPubMedSearch in Google Scholar
  • 4 Williams B, Mancia G, Spiering W. et al; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018; 39 (33) 3021-3104
    CrossrefPubMedSearch in Google Scholar
  • 5 Williams B, Mancia G. Ten commandments of the 2018 ESC/ESH HTN guidelines on hypertension in adults. Eur Heart J 2018; 39 (33) 3007-3008
    CrossrefPubMedSearch in Google Scholar
  • 6 Pradhan A, Vishwakarma P. Decoding the 2017 hypertension guidelines: the ten commandments. Heart India 2017; 5: 139-144
    PubMedSearch in Google Scholar
  • 7 American College of Cardiology. ASCVD Risk Predictor Plus. Accessed on May 5, 2021 at: http://tools.acc.org/ASCVD-Risk-Estimator-Plus/#!/calculate/estimate/
    PubMed
  • 8 Piepoli MF, Hoes AW, Agewall S. et al; ESC Scientific Document Group. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016; 37 (29) 2315-2381
    CrossrefPubMedSearch in Google Scholar
  • 9 Thomopoulos C, Parati G, Zanchetti A. Effects of blood pressure-lowering on outcome incidence in hypertension: 5. Head-to-head comparisons of various classes of antihypertensive drugs - overview and meta-analyses. J Hypertens 2015; 33 (07) 1321-1341
    CrossrefPubMedSearch in Google Scholar
  • 10 Ettehad D, Emdin CA, Kiran A. et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 2016; 387 (10022): 957-967
    CrossrefPubMedSearch in Google Scholar
  • 11 Law MR, Wald NJ, Morris JK, Jordan RE. Value of low dose combination treatment with blood pressure lowering drugs: analysis of 354 randomised trials. BMJ 2003; 326 (7404): 1427
    CrossrefPubMedSearch in Google Scholar
  • 12 Wald DS, Law M, Morris JK, Bestwick JP, Wald NJ. Combination therapy versus monotherapy in reducing blood pressure: meta-analysis on 11,000 participants from 42 trials. Am J Med 2009; 122 (03) 290-300
    CrossrefPubMedSearch in Google Scholar
  • 13 Corrao G, Parodi A, Zambon A. et al. Reduced discontinuation of antihypertensive treatment by two-drug combination as first step. Evidence from daily life practice. J Hypertens 2010; 28 (07) 1584-1590
    CrossrefPubMedSearch in Google Scholar
  • 14 Gupta AK, Arshad S, Poulter NR. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis. Hypertension 2010; 55 (02) 399-407
    CrossrefPubMedSearch in Google Scholar
  • 15 Coca A, Agabiti-Rosei E, Cifkova R, Manolis AJ, Redón J, Mancia G. The polypill in cardiovascular prevention: evidence, limitations and perspective - position paper of the European Society of Hypertension. J Hypertens 2017; 35 (08) 1546-1553
    CrossrefPubMedSearch in Google Scholar