Hypertension Stricter hypertension guidelines provided

New European guidelines for hypertension

Hypertension is a widespread disease, especially in the Western world. In Germany alone, about 20 to 30 million people are affected. But how high are blood pressure values ​​to be considered healthy? The European professional societies have now presented new guidelines. The experts define hypertension differently than physicians in the US.

Every third German citizen affected

According to health experts, every third German suffers from high blood pressure or hypertension, as the silent suffering of medical professionals is called. Until recently, hypertension was defined by a systolic blood pressure greater than 140 mmHg or a diastolic blood pressure greater than 90 mmHg. But lately, voices have grown that say that 120 instead of 140 should be the new blood pressure target. US medical societies have lowered the blood pressure guidelines a few months ago (now 130/80 mmHg). Since then, there are up to 40 percent more than hypertensive patients. However, the European professional societies do not define hypertension in the new guidelines as their US counterparts.

In the US, the limits for hypertension were lowered last year. However, the new European Guidelines maintain the existing definition of disease. (Image: torsak / fotolia.com)

New European guidelines for the treatment of hypertension

As reported by the German High Pressure League (DHL), the new European guidelines for the treatment of hypertension were presented for the first time at the congress of the "European Society of Hypertension" (ESH).

The new guidelines continue to adhere to the existing disease definition of ≥140 / 90 mm Hg, but recommend a reduction to the normal range (<130/80 mm Hg) anzustreben.

"The US guidelines define high blood pressure as low as ≥130 / 80 mm Hg," said Professor Dr. med. med. Peter Trenkwalder, Deputy. CEO of DHL.

The limit was lowered in 2017 in response to the SPRINT study.

Differentiation between optimal and high normal blood pressure range

"The European Commission for Guidelines, on the other hand, did not see sufficient evidence for such a recommendation. The new guideline also stipulates that the majority of hypertensive patients will only be treated with medication at a blood pressure of 140/90 mm Hg, "Dr. Trenkwalder.

According to DHL, it differentiates like the previous guideline between an optimal blood pressure range (<120/80 mm Hg), einem normalen (120-129/80-84 mm Hg) und einem hochnormalen (130-139/85-89 mm Hg).

Above values ​​are therefore classified as pathological and should be treated with medication if a lifestyle change already recommended for patients with high normal values ​​has not been successful.

Lower blood pressure naturally

Hypertension can often be reduced even without medication. In particular, people who are overweight will usually lose weight.

In addition, they should move regularly and refrain from smoking and excessive alcohol consumption. Even a well-balanced, healthy diet can help lower blood pressure.

Very important here is: salt only in moderation. A high salt diet can increase blood pressure. Not more than four to six grams of salt should be consumed per day.

It should be noted that also in most finished products often large amounts of salt are included.

The diet should generally contain a lot of fruits and vegetables. Especially recommended are garlic, beetroot juices and hawthorn.

Also recommended is Mediterranean fare with olive oil and vegetables, as British researchers could show.

In addition, stress relief exercises such as yoga or autogenic training can be very effective and have a positive effect on high blood pressure levels.

Some home remedies for hypertension such as Kneipp's applications can provide good support.

Modern hypertension therapy should be individualized

But in some cases, a healthier lifestyle is not enough to lower your blood pressure. Then drugs are needed.

According to DHL's President, Professor Krämer, "hypertension is a complex disease picture and modern hypertension therapy should be individualized; the guidelines merely set the rough framework."

"Primary target must be, all hypertensive patients successfully below this value of 140/90 mm Hg, if possible in the normal range (<130/80 mm Hg) zu bringen. Doch derzeit ist die Hälfte aller Menschen mit Bluthochdruck nicht bzw. nicht erfolgreich behandelt“, so der Experte.

The reasons for this would be a lack of adherence to therapy of the patients and a still existing dark-figure of the disease.

These two issues address the new guideline, which DHL expressly welcomes. First, it recommends that normotensive adults with optimal blood pressure levels below 120/80 mmHg receive a blood pressure screening measurement every five years and adults with high normal blood pressure levels (130-139 / 85-89 mmHg) at least annually.

To increase adherence, it recommends the use of single-pill combinations (SPCs) in a single tablet - it is known that adherence to medication decreases as more tablets are used the patients have to take.

Accordingly, a paradigm shift in therapy has emerged: "The drug therapy is now primarily as a 2-fold combination therapy of ACE inhibitors or angiotensin receptor blocker (ARB) and calcium antagonist or Thiaziddiuretikum done, the monotherapy has served as a first-line therapy" explained Professor Krämer. (Ad)