The American Heart Association (AHA) and American College of Cardiology (ACC), along with numerous other professional societies, have released updated guidance on hypertension. The 105-page document updates previous guidance from 2017.
Key recommendations include the importance of accurate blood pressure measurement, particularly in healthcare settings, where it is often overlooked. The authors emphasize the need for regular home-based monitoring to supplement office visits, which has been shown to lead to clinically significant blood pressure reductions.
The guidelines also support the use of single-pill combination drugs for patients with stage 2 hypertension, citing both efficacy and efficiency benefits. However, caution is warranted regarding renal denervation (RDN), a procedure that has sparked controversy due to its limited evidence base and potential risks.
A major concern raised by the author is the use of the new PREVENT risk score in the guidelines, which may lead to undertreatment of blood pressure. The author questions the absence of comparative trials between PREVENT and the pooled cohort equation (PCE) as a risk modifier.
The updated guidance also includes recommendations for hypertension treatment based on overall cardiovascular risk, using the PREVENT risk score. While this approach has its advantages, the author worries that it may lead to undertreatment of blood pressure in certain populations.
Overall, the AHA and ACC’s updated hypertension guidelines aim to provide evidence-based recommendations for the prevention and management of high blood pressure. However, as with any medical guideline, there are potential risks and uncertainties associated with its implementation.
Source: https://www.medscape.com/viewarticle/new-blood-pressure-guidelines-4-thing-i-and-2-concerns-2025a1000m1x