In a nutshell
The 2013 European Society of Hypertension/European Society of Cardiology (2013 ESH/ESC) guidelines are meant to provide doctors with the most recent data regarding the best management of hypertension (high blood pressure).
Some background
The proper management of hypertension (HTN) is crucial since patients with high blood pressure are at a high risk for cardiovascular diseases (CVDs) and kidney failure. Cardiovascular diseases (CVDs) are a class of diseases that involve the heart, the blood vessels, or both (such as heart attacks and strokes for example). Kidney failure is a condition in which the kidneys fail to adequately filter waste products from the blood. In order to ensure the proper management of HTN according to the most recent medical research, the ESH/ESC publish a yearly guideline article including the latest expert recommendations.
Methods & findings
According to the 2013 ESH/ESC guidelines, lifestyle (defined as the typical way of life of an individual) remains a top priority in the prevention and management of HTN. The recommended lifestyle changes to reduce HTN include regular physical exercise, moderate drinking of alcohol, weight reduction and maintenance, smoking cessation, and limited salt consumption. According to the guidelines, alcohol consumption should not exceed 140 gram per week for men and 80 gram per week for women. The guidelines also state that reduced salt intake (to about 5 grams per day) can reduce blood pressure by 4 to 5 mmHg in HTN individuals. Recent trials have also showed that reduced salt intake is directly associated with a lower risk of developing CVDs.
Recent studies have also shown that a Mediterranean diet is beneficial in reducing the risk of CVD, and keeping to a Mediterranean diet has been added as a standing recommendation to the 2013 guidelines. According to the guidelines, hypertensive patients should eat fish at least twice a week, and include 300 to 400 grams a day of fruits and vegetables in their diet.
The 2013 ESH/ESC guidelines suggest that overall, all antihypertensive drugs currently used are suitable for the management of hypertension. However, combination therapy (the use of more than one class of drugs) achieves better blood pressure control and reduces the risk of patient drop-out from treatment. The combination of two drugs with a similar mode of action is not recommended. For example, patients should not be treated with more than one antagonist of the renin angiotensin system (RAS). RAS antagonists include renin inhibitors, angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs).
In light of recent studies, the 2013 ESH/ESC guidelines suggest that therapy should also be guided according to the risk of specific organ damage. A complete risk assessment for CVDs, kidney damage and other concurrent conditions should be performed for each patient, and additional risk factors for these conditions should be aggressively treated as well.
The bottom line
The 2013 ESH/ESC guidelines emphasize that both lifestyle changes and drug therapy are needed to properly manage hypertension.
What’s next?
Consult with your physician regarding the optimal management of hypertension according to the most recent practical guidelines.
Published By :
Journal of hypertension
Date :
Jul 01, 2013
