European guidelines for hypertension in 2024: a comparison of key recommendations for clinical practice

Lucas Lauder^#^{1

2}, Thomas Weber^#³, Michael Böhm⁴, Sofie Brouwers^{5

6}, Rosa Maria Bruno^{7

8}, Eva Gerdts^{9

10}, Reinhold Kreutz¹¹, Thomas F Lüscher^{12

13}, Giuseppe Mancia¹⁴, John William McEvoy¹⁵, Richard J McManus¹⁶, Mpiko Ntsekhe¹⁷, Gianfranco Parati^{18

19}, Atul Pathak²⁰, Rosa de Pinho²¹, Kazem Rahimi²², Pantelis Sarafidis²³, Aletta E Schutte^{24

25}, Bryan Williams²⁶, Rhian M Touyz²⁷, Felix Mahfoud^{28

29}

Affiliations

¹ Department of Cardiology, University Heart Center, University Hospital Basel, Basel, Switzerland. lucas.lauder@usb.ch.
² Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland. lucas.lauder@usb.ch.
³ Department of Internal Medicine II, Cardiology and Intensive Care Medicine, Klinikum Wels-Grieskirchen, Wels, Austria.
⁴ HOMICAREM (Homburg Institute for CardioRenalMetabolic Medicine) and Klinik für Innere Medizin III, Saarland University, Homburg, Germany.
⁵ Department of Cardiology, Cardiovascular Center Aalst, AZORG Clinic Aalst, Aalst, Belgium.
⁶ Department of Experimental Pharmacology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
⁷ Université Paris Cité, Inserm, PARCC, Paris, France.
⁸ Pharmacology and Hypertension Unit, AP-HP, Hôpital Européen Georges Pompidou, Paris, France.
⁹ Department of Clinical Science, University of Bergen, Bergen, Norway.
¹⁰ Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
¹¹ Institute of Clinical Pharmacology and Toxicology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
¹² Heart Division, Royal Brompton & Harefield Hospitals GSTT and Cardiovascular Academic Group, King's College, London, UK.
¹³ Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland.
¹⁴ University of Milano-Bicocca, Milan, Italy.
¹⁵ National Institute for Prevention and Cardiovascular Health and University of Galway School of Medicine, Galway, Ireland.
¹⁶ Brighton and Sussex Medical School, Universities of Brighton and of Sussex, Brighton, UK.
¹⁷ The Cardiac Clinic Groote Schuur Hospital and Division of Cardiology, Faculty of Health Sciences University of Cape Town, Cape Town, South Africa.
¹⁸ Department of Cardiology, IRCCS San Luca Hospital, Istituto Auxologico Italiano, Milan, Italy.
¹⁹ Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
²⁰ National Institute of Cardiology, Cardiovascular Surgery and Interventional Cardiology (INCCI), Luxembourg City, Luxembourg.
²¹ Primary Care Unit, Unidade Local de Saúde de Entre Douro e Vouga, São João da Madeira, Portugal.
²² Deep Medicine, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK.
²³ 1st Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece.
²⁴ School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
²⁵ The George Institute for Global Health, Sydney, New South Wales, Australia.
²⁶ University College London, London, UK.
²⁷ Research Institute of McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
²⁸ Department of Cardiology, University Heart Center, University Hospital Basel, Basel, Switzerland. felix.mahfoud@usb.ch.
²⁹ Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland. felix.mahfoud@usb.ch.

^# Contributed equally.

PMID: 40691360
DOI: 10.1038/s41569-025-01187-2

Practice Guideline

European guidelines for hypertension in 2024: a comparison of key recommendations for clinical practice

Lucas Lauder et al. Nat Rev Cardiol. 2025 Sep.

. 2025 Sep;22(9):675-688.

doi: 10.1038/s41569-025-01187-2. Epub 2025 Jul 21.

Authors

Affiliations

¹ Department of Cardiology, University Heart Center, University Hospital Basel, Basel, Switzerland. lucas.lauder@usb.ch.
² Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland. lucas.lauder@usb.ch.
³ Department of Internal Medicine II, Cardiology and Intensive Care Medicine, Klinikum Wels-Grieskirchen, Wels, Austria.
⁴ HOMICAREM (Homburg Institute for CardioRenalMetabolic Medicine) and Klinik für Innere Medizin III, Saarland University, Homburg, Germany.
⁵ Department of Cardiology, Cardiovascular Center Aalst, AZORG Clinic Aalst, Aalst, Belgium.
⁶ Department of Experimental Pharmacology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
⁷ Université Paris Cité, Inserm, PARCC, Paris, France.
⁸ Pharmacology and Hypertension Unit, AP-HP, Hôpital Européen Georges Pompidou, Paris, France.
⁹ Department of Clinical Science, University of Bergen, Bergen, Norway.
¹⁰ Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
¹¹ Institute of Clinical Pharmacology and Toxicology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
¹² Heart Division, Royal Brompton & Harefield Hospitals GSTT and Cardiovascular Academic Group, King's College, London, UK.
¹³ Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland.
¹⁴ University of Milano-Bicocca, Milan, Italy.
¹⁵ National Institute for Prevention and Cardiovascular Health and University of Galway School of Medicine, Galway, Ireland.
¹⁶ Brighton and Sussex Medical School, Universities of Brighton and of Sussex, Brighton, UK.
¹⁷ The Cardiac Clinic Groote Schuur Hospital and Division of Cardiology, Faculty of Health Sciences University of Cape Town, Cape Town, South Africa.
¹⁸ Department of Cardiology, IRCCS San Luca Hospital, Istituto Auxologico Italiano, Milan, Italy.
¹⁹ Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
²⁰ National Institute of Cardiology, Cardiovascular Surgery and Interventional Cardiology (INCCI), Luxembourg City, Luxembourg.
²¹ Primary Care Unit, Unidade Local de Saúde de Entre Douro e Vouga, São João da Madeira, Portugal.
²² Deep Medicine, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK.
²³ 1st Department of Nephrology, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece.
²⁴ School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.
²⁵ The George Institute for Global Health, Sydney, New South Wales, Australia.
²⁶ University College London, London, UK.
²⁷ Research Institute of McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
²⁸ Department of Cardiology, University Heart Center, University Hospital Basel, Basel, Switzerland. felix.mahfoud@usb.ch.
²⁹ Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland. felix.mahfoud@usb.ch.

^# Contributed equally.

PMID: 40691360
DOI: 10.1038/s41569-025-01187-2

Abstract

Hypertension is the most prevalent modifiable risk factor for cardiovascular disease and for cardiovascular and all-cause mortality globally. Suboptimal control of elevated blood pressure places a substantial burden on health-care systems worldwide. Several factors contribute to this suboptimal control, such as limited awareness of hypertension, lack of appropriate diagnosis and poor control of blood pressure among those with a diagnosis. These factors can be due to patient non-adherence to treatment, inertia among health-care professionals and low uptake and implementation of clinical guideline recommendations. From 2003 to 2018, the European Society of Hypertension and the European Society of Cardiology jointly published four sets of guidelines on hypertension. However, the two societies released separate guidelines on hypertension in 2023 and 2024, respectively. These two sets of European guidelines agree on most recommendations, but some differences have been identified. In this Expert Recommendation, we highlight the key consensus recommendations from the two guidelines; compare differing approaches to the definition, classification, diagnosis and treatment of hypertension; and aim to help health-care professionals in their decision-making to improve the management of hypertension and to reduce the burden of hypertension-associated outcomes and premature deaths.

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Conflict of interest statement

Competing interests: L.L. has received speaker honoraria from AstraZeneca, Medtronic, Pfizer and Recor Medical, and advisory fees from Medtronic and Recor Medical. T.W. has received speaker honoraria and advisory fees from AstraZeneca, Bayer, BMS, Boehringer Ingelheim, Gedeon Richter, Medtronic, Menarini, Merck, Pfizer, Recor and Servier. M.B. has received personal fees from Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Cytokinetics, Medtronic, Novartis, Recor, Servier and Vifor. S.B. reports speaker/consulting fees to the department from Amgen, Daiichi Sankyo, Medtronic, Merck, Novartis, Recor Medical, Sanofi and Servier. R.M.B. reports speaker honoraria from El Kendi and Servier, and has received devices on free loan from Quipu, Unex and Visualsonics-Fujifilm. E.G. has received honoraria for a lecture at a seminar from Amgen and Boehringer Ingelheim. R.K. has received honoraria for consultancy, lectures and support for research from AstraZeneca, Bayer, Krka, Menarini Group, Merck, PolPharma, ProMed, Recor, Sanofi and Servier. G.M. has received compensation as a speaker, chairman and/or consultant from Berlin Chemie, IPCA Laboratories, Medtronic, Menarini, Merck Healthcare, Omnicuris, Recordati, Sanofi, Servier and Sun Laboratories. R.J.M. has received institutional payments for licensing and consulting from Omron concerning a telemonitoring system. G.P. has received speaker honoraria from Merck, Omron, Somnomedics and Viatris. R.d.P. has received speaker honoraria from Merck, Servier and Tecnimede. K.R. has received honoraria to his institution for an advisory role to Medtronic, and has received funding for research from the European Union, Medical Research Council, Novo Nordisk, Roche and UK Research and Innovation. P.S. has received advisory honoraria from Astellas, AstraZeneca, Baxter, Bayer, Boehringer Ingelheim, Healthink, Menarini, Primeview and Recor Medical, and has received speaker honoraria from AICME, Astellas, AstraZeneca, Bayer, Boehringer Ingelheim, Genesis Pharma, Menarini, Peervoice, Science Collected, Springer and WebMD, and has received institutional research support from Boehringer Ingelheim, Genesis Pharma, Menarini and Vianex. A.E.S. has received speaker honoraria from Abbott, Aktiia, AstraZeneca, Medtronic, Omron, Sanofi and Servier, and serves on scientific advisory boards for Medtronic, SiSU Health and Sky Labs. B.W. is the Chief Scientific and Medical Officer at the British Heart Foundation, chairs and/or serves on the scientific steering committees of clinical trials of currently unlicensed new medicines supported by Alnylam, AstraZeneca and Novartis, and has provided scientific advice to Anlia and Eli Lilly. F.M. has received speaker honoraria/consulting fees from Ablative Solutions, AstraZeneca, Inari, Medtronic, Merck, Novartis, Philips and Recor Medical, and Saarland University has received scientific support from Ablative Solutions, Medtronic and Recor Medical. The other authors declare no competing interests.

References

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European guidelines for hypertension in 2024: a comparison of key recommendations for clinical practice

Affiliations

European guidelines for hypertension in 2024: a comparison of key recommendations for clinical practice

Authors

Affiliations

Abstract

Conflict of interest statement

References

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LinkOut - more resources

Full Text Sources

Medical