[Management of hypertension (ESC Guideline 2007/DHL Guideline 2008)]

Abstract

The 2007 ESH/ESC (European Society of Hypertension/European Society of Cardiology) guidelines for the management of arterial hypertension focus on the individual patient with his specific cardiovascular risk profile. The existing hypertension classification remains the same as in previous editions. However, specific patient characteristics and risk profiles require a more individualized approach. Recommended diagnostic procedures have been extended in order to detect existing subclinical organ damage and/or established cardiovascular or renal diseases at an early stage. Urgency and mode of therapeutic approach can directly be derived from the relevant risk stratification matrix which continues to be an integral component of the current guidelines. The primary goal of treatment of the hypertensive patient is to achieve a maximum reduction in the long-term total risk of cardiovascular morbidity and mortality. Since blood pressure lowering per se is thought to be of major importance to achieve these goals, a number of well-established pharmaceutical substances remain at hand of the practitioner. In addition, lifestyle changes are increasingly regarded to be of high importance. In patients with established comorbidities and in young subjects the choice of a specific pharmaceutical substance class is fundamental. The gap between guideline recommendations and poor blood pressure control in medical practice remains and needs to be closed. Therefore, a collective striving of all parties involved for early detection and effective treatment is needed to overcome the current and future burden of arterial hypertension.