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Comparison Among Recommendations for the Management of Arterial Hypertension Issued by Last US, Canadian, British and European Guidelines

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Abstract

Guidelines for the management of hypertension have been issued by different hypertension societies or organizations. Despite many similarities one can identify major differences in the diagnosis, management and treatment of the hypertensive patients among ESH/ESC, NICE, Canadian and NJC8 guidelines. Differences that can be identified are in the definition of hypertension in the elderly population, the optimal blood pressure targets in different hypertensive populations such as patients with diabetes and chronic kidney disease patients and the choose of the initial and appropriate antihypertensive agent depending on comorbidities of the treated population. Everyday clinical praxis physicians are confused by these differences and these incongruities contribute to doctor and patient inertia to reduce blood pressure levels at an optimal level. Community physicians cannot easily distinguish what recommendations are the best to be used for their patients. The critical view of these differences can also help the guidelines committees to make appropriate changes and finally to agree to a global view of recommendations for the management and treatment of hypertension.

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References

  1. NICE Hypertension in adults: diagnosis and management. 2016.

  2. Mancia G, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31(7):1281–357.

    Article  CAS  PubMed  Google Scholar 

  3. James PA, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama. 2014;311(5):507–20.

    Article  CAS  PubMed  Google Scholar 

  4. Stern RH. The new hypertension guidelines. J Clin Hypertens (Greenwich). 2013;15(10):748–51.

    Google Scholar 

  5. Kotsis V, et al. New developments in the pathogenesis of obesity-induced hypertension. J Hypertens. 2015;33(8):1499–508.

    Article  CAS  PubMed  Google Scholar 

  6. Kotsis V, Stabouli S. Fitness, nighttime blood pressure and vascular ageing in type 2 diabetes. Hypertens Res. 2011;34(7):799–800.

    Article  PubMed  Google Scholar 

  7. Kotsis V, et al. Impact of obesity on 24-hour ambulatory blood pressure and hypertension. Hypertension. 2005;45(4):602–7.

    Article  CAS  PubMed  Google Scholar 

  8. Kotsis V, et al. Arterial stiffness and 24 h ambulatory blood pressure monitoring in young healthy volunteers: the early vascular ageing Aristotle University Thessaloniki Study (EVA-ARIS Study). Atherosclerosis. 2011;219(1):194–9.

    Article  CAS  PubMed  Google Scholar 

  9. Stabouli S, et al. Adolescent obesity is associated with high ambulatory blood pressure and increased carotid intimal-medial thickness. J Pediatr. 2005;147(5):651–6.

    Article  PubMed  Google Scholar 

  10. Staessen JA, et al. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators. Jama. 1999;282(6):539–46.

    Article  CAS  PubMed  Google Scholar 

  11. Staessen JA, et al. Ambulatory pulse pressure as predictor of outcome in older patients with systolic hypertension. Am J Hypertens. 2002;15(10 Pt 1):835–43.

    Article  PubMed  Google Scholar 

  12. American Diabetes Association. 9. Cardiovascular disease and risk management. Diabetes Care 2017;40(Suppl 1):S75–S87.

  13. Anders HJ, Andersen K, Stecher B. The intestinal microbiota, a leaky gut, and abnormal immunity in kidney disease. Kidney Int. 2013;83(6):1010–6.

    Article  CAS  PubMed  Google Scholar 

  14. Conroy RM, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. 2003;24(11):987–1003.

    Article  CAS  PubMed  Google Scholar 

  15. Hippisley-Cox J, et al. Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: prospective open cohort study. Bmj. 2007;335(7611):136.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Walther D, et al. Hypertension, diabetes and lifestyle in the long-term—results from a Swiss population-based cohort. Prev Med. 2016;97:56–61.

    Article  PubMed  Google Scholar 

  17. Radzeviciene L, Ostrauskas R. Adding salt to meals as a risk factor of type 2 diabetes mellitus: a case–control study. Nutrients. 2017;9(1):67. doi:10.3390/nu9010067.

    Article  PubMed Central  Google Scholar 

  18. Rust P, Ekmekcioglu C. Impact of salt intake on the pathogenesis and treatment of hypertension. Adv Exp Med Biol. 2016.

  19. Byrne DW, et al. Modifiable healthy lifestyle behaviors: 10-year health outcomes from a health promotion program. Am J Prev Med. 2016;51(6):1027–37.

    Article  PubMed  Google Scholar 

  20. Cunha RM, et al. Acute blood pressure response in hypertensive elderly women immediately after water aerobics exercise: a crossover study. Clin Exp Hypertens. 2017;39(1):17–22.

    Article  PubMed  Google Scholar 

  21. Bruno RM, et al. Association between lifestyle and systemic arterial hypertension in young adults: a national, survey-based, cross-sectional study. High Blood Press Cardiovasc Prev. 2016;23(1):31–40.

    Article  CAS  PubMed  Google Scholar 

  22. Broderstad AR, Melhus M. Prevalence of metabolic syndrome and diabetes mellitus in Sami and Norwegian populations. The SAMINOR-a cross-sectional study. BMJ Open. 2016;6(4):e009474.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Zhang P, et al. Impact of intensive lifestyle intervention on preference-based quality of life in type 2 diabetes: Results from the Look AHEAD trial. Obesity (Silver Spring). 2016;24(4):856–64.

    Article  Google Scholar 

  24. Griffin BA. Nonpharmacological approaches for reducing serum low-density lipoprotein cholesterol. Curr Opin Cardiol. 2014;29(4):360–5.

    Article  PubMed  Google Scholar 

  25. Alvarez LC, et al. Metabolic response to high intensity exercise training in sedentary hyperglycemic and hypercholesterolemic women. Rev Med Chil. 2013;141(10):1293–9.

    Article  Google Scholar 

  26. Koeth RA, et al. Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med. 2013;19(5):576–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Ruzicka M, et al. Canadian Society of Nephrology commentary on the 2012 KDIGO clinical practice guideline for the management of blood pressure in CKD. Am J Kidney Dis. 2014;63(6):869–87.

    Article  PubMed  Google Scholar 

  28. Kotsis V, et al. Target organ damage in “white coat hypertension” and “masked hypertension”. Am J Hypertens. 2008;21(4):393–9.

    Article  PubMed  Google Scholar 

  29. Beckett NS, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358(18):1887–98.

    Article  CAS  PubMed  Google Scholar 

  30. Piepoli MF, et al. 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. G Ital Cardiol (Rome). 2017;18(7):547–612.

    Google Scholar 

  31. Perk J, et al. European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). G Ital Cardiol (Rome). 2013;14(5):328–92.

    Google Scholar 

  32. Elmer PJ, et al. Effects of comprehensive lifestyle modification on diet, weight, physical fitness, and blood pressure control: 18-month results of a randomized trial. Ann Intern Med. 2006;144(7):485–95.

    Article  PubMed  Google Scholar 

  33. Frisoli TM, et al. Beyond salt: lifestyle modifications and blood pressure. Eur Heart J. 2011;32(24):3081–7.

    Article  PubMed  Google Scholar 

  34. Romero R, et al. Undiagnosed obesity in hypertension: clinical and therapeutic implications. Blood Press. 2007;16(6):347–53.

    Article  PubMed  Google Scholar 

  35. Neter JE, et al. Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2003;42(5):878–84.

    Article  CAS  PubMed  Google Scholar 

  36. Pimenta E, et al. Effects of dietary sodium reduction on blood pressure in subjects with resistant hypertension: results from a randomized trial. Hypertension. 2009;54(3):475–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Graudal NA, Hubeck-Graudal T, Jurgens G. Effects of low-sodium diet vs. high-sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride (Cochrane Review). Am J Hypertens. 2012;25(1):1–15.

    Article  CAS  PubMed  Google Scholar 

  38. He FJ, MacGregor GA. How far should salt intake be reduced? Hypertension. 2003;42(6):1093–9.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. 3rd Department of Internal Medicine, Hypertension-24h ambulatory blood pressure monitoring center, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Christina Antza, Ioannis Doundoulakis & Vasilios Kotsis

  2. 1st Department of Pediatrics, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Stella Stabouli

Authors
  1. Christina Antza
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  2. Ioannis Doundoulakis
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  3. Stella Stabouli
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  4. Vasilios Kotsis
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Correspondence to Vasilios Kotsis.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Antza, C., Doundoulakis, I., Stabouli, S. et al. Comparison Among Recommendations for the Management of Arterial Hypertension Issued by Last US, Canadian, British and European Guidelines. High Blood Press Cardiovasc Prev 25, 9–16 (2018). https://doi.org/10.1007/s40292-017-0236-x

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  • DOI: https://doi.org/10.1007/s40292-017-0236-x

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