Managing hypertension: recommendations from the experts

This study reviewed data on the management of hypertension and made recommendations.

Hypertension (high blood pressure) is a common condition that requires strict blood pressure (BP) control. Uncontrolled hypertension can lead to heart disease, stroke, and death. Hypertension can be treated using medication or by lifestyle changes e.g. exercise and diet. Medications used to manage BP, are called anti-hypertensives.

Managing hypertension involves a number of factors. Each factor should be taken into consideration when treating a patient and controlling BP. The European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) have released updated recommendations on managing hypertension. The previous review was conducted in 2013.

This study reviewed recommendations for diagnosing and treating hypertension.

Setting targets for BP management: Patients with blood pressure ranging 130-139/80-89 mmHg are classified as ‘high-normal’. Patients with a BP greater than 140/90 mmHg should aim to reduce it below this level first. If this target is reached patients should aim to reduce BP to 130-139 mmHg. In patients older than 65 years, BP should not be lowered below 130 mmHg.

Treatment for hypertension: Lifestyle changes should be the first line of treatment. Patients should consume less than 5 grams of salt per day. Alcohol intake should be limited to 14 units per week for men and 8 units per week for women. Patients should eat more vegetables, fresh fruit, fish and nuts and unsaturated fats (e.g. olive oil) and less of red meat and high-fat dairy products. At least 30 minutes of aerobic exercise 5-7 days per week is advised.

Patients should aim to have a healthy body mass index (BMI; a measurement of weight in relation to height) between 20-25 and smoking should be avoided. Anti-hypertensive drugs can be prescribed if lifestyle changes are not effective at lowering BP. The choice of anti-hypertensive drugs depends on each patient's BP values, other medical conditions, or age.

This review discussed recent guidelines on managing hypertension.