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Review
. 2025 Mar;82(3):432-444.
doi: 10.1161/HYPERTENSIONAHA.124.24173. Epub 2024 Dec 31.

What Is New and Different in the 2024 European Society of Cardiology Guidelines for the Management of Elevated Blood Pressure and Hypertension?

Cian P McCarthy  1 , Rosa Maria Bruno  1   2 , Kazem Rahimi  3 , Rhian M Touyz  4 , John W McEvoy  5   6
Affiliations
Review

What Is New and Different in the 2024 European Society of Cardiology Guidelines for the Management of Elevated Blood Pressure and Hypertension?

Cian P McCarthy et al. Hypertension. 2025 Mar.

Abstract

In 2024, the European Society of Cardiology released a new guideline for the management of elevated blood pressure (BP) and hypertension. The guideline introduced a new BP categorization: (1) nonelevated (office BP <120/70 mm Hg) for which drug treatment is not recommended, (2) elevated (120-139/70-89 mm Hg) for which drug treatment is recommended based on cardiovascular disease risk and follow-up BP level, and (3) hypertension (≥140/90 mm Hg) for which prompt confirmation and drug treatment are recommended in most individuals. The initial default systolic BP treatment target is 120 to 129 mm Hg; however, relaxed targets (BP as low as reasonably achievable) are recommended in case of treatment intolerance, adults ≥85 years, symptomatic orthostasis, moderate-to-severe frailty, or limited life expectancy. Here, we summarize what is new and different in the 2024 European Society of Cardiology guidelines, relative to other major international hypertension guidelines in Europe and America. Our aim is to reconcile any uncertainty clinicians may have about implementing these various guidelines in patient care.

Keywords: blood pressure; cardiovascular diseases; guideline; hypertension; risk.

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Conflict of interest statement

C.P. McCarthy has received consulting fees/honorarium from Roche Diagnostic, Abbott Laboratories, New Amsterdam Pharma, and HeartFlow, Inc. K. Rahimi’s institution has received fees from Medtronic. The other authors report no conflicts.

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