Newly published high blood pressure guideline From when high blood pressure requires a therapy

These are the new guidelines for hypertension

At the Congress of the European Society of Cardiology (ESC) in Munich, the new guidelines for the treatment of hypertension have been presented. These were expected with great interest, because in the US last year the values ​​for treatment were adjusted.

contents

• These are the new guidelines for hypertension
• Europe vs. United States
• Less salt, more exercise

Europe is not weakening on this point. The limits remain basically at 140/90 mmHg - this corresponds to the previous recommendations. However, elderly patients sometimes accept higher thresholds of up to 160 mmHg, "to avoid unwanted side effects from over-intensive drug therapy," said Andrea Podczeck-Schweighofer, President of the Austrian Society of Cardiology (ÖKG).

The European limit values ​​remain unchanged. (Image: New Africa / fotolia.com)

In certain cases, medication should be given already in the range of normal blood pressure in the upper range (130-139 / 85-89 mmHg). "Namely, if there is a particularly high cardiovascular risk due to a cardiovascular disease," said Podczeck-Schweighofer.

The treatment goal of a therapy is still a reduction to below 140/90 mmHg. In case of well-tolerated therapy, 130 mmHg should be sought as the systolic value, and in patients under the age of 65, as much as 120 to 129 mmHg. Target values ​​below 120 mmHg are counterproductive for all patient groups because the risks outweigh the potential benefits.

Europe vs. United States

Hypertension from 130/80 mmHg has been reported in the USA since last year. However, patients requiring blood pressure beyond 130/80 mmHg in the new US guidelines are considered to be in need of medication only if they have other risk factors. Other patients should be treated with general measures. "But even so, according to the new US guidelines in the US alone, about four million people are additionally in need of medication treatment, which would not be a threshold of 140/90 mmHg," says Podczeck-Schweighofer.

New in the recently published European blood pressure guideline is a treatment recommendation at the start of therapy. Accordingly, the majority of high-pressure patients in the future should carry out a treatment with two different acting substances from the beginning. So far, it was recommended to start with a drug first and only if necessary to use a second or third drug. "In this context, the new guideline notes that combined preparations containing the substances in one tablet should increase adherence," said the ECOC President.

Less salt, more exercise

If hypertension can not be adequately controlled with a combination of three antihypertensive agents, a diuretic should also be added, as recommended. "Lifestyle modifications are also recommended in the new ESC guideline for all high-pressure patients," adds Podczeck-Schweighofer. These include a reduction in salt intake, a healthy diet, regular exercise, abstinence from nicotine and striving for normal weight. To the recent recommendation to consume alcohol only moderately, now comes the explicit indication that so-called coma or binge drinking is an absolute taboo.

Healthy diet is important in lowering blood pressure. (Image: benjaminnolte / fotolia.com)

With regard to hypertension and cancer, it is noted that a temporary discontinuation of cancer treatment may be considered when very high blood pressure levels are not controllable with combination therapy alone.

Also new is a recommendation on hypertension and physical exertion in the high mountains. Patients with high blood pressure should be advised to go on excursions up to 4,000 meters above sea level. renounce.

Last but not least, attention is drawn to the health risks of hypertension. This is, for example, a significant risk factor for strokes. It also increases the risk of heart failure, atrial fibrillation, renal insufficiency, peripheral obstructive disease or dementias such as Alzheimer's disease. (Fs)