European experts in hypertension take a flexible approach to defining and treating high blood pressure, but the European and US guidelines are not really that far apart, said Dr Giuseppe Mancia, chairman of the department of medicine at the University of Milan-Bicocca. “The European goal is reduction of long term cardiovascular risk,” he said at the American Society of Hypertension meeting in New York last weekend.
Figure 1
US guidelines suggest that the risk of cardiovascular disease begins at 115/75 mm Hg
Credit: JUSTIN SULLIVAN/GETTY
Last year the US guidelines said that the risk of cardiovascular disease began at 115/75 mm Hg and called systolic pressures of 120 to 130 mm Hg and diastolic pressures of 80 to 89 mm Hg “prehypertension.” Thiazide-type diuretics were recommended for most patients, but two or more drugs would usually be needed to control hypertension (BMJ2003;326: 1104g [PMC free article] [PubMed] [Google Scholar]).
The European guidelines say optimal blood pressure is below 120/80 mm Hg; normal blood pressure is 120-129 mm Hg systolic and 80-84 mm Hg diastolic; and “high normal” is 130-139 mm Hg systolic and 85-89 mm Hg diastolic. The guidelines categorise patients' cardiovascular risk depending on the presence of factors such as older age, smoking, dyslipidaemia, and family history of early cardiovascular disease, as well as considering signs of damage to the left ventricle, kidneys, or arterial wall and whether the patient has diabetes.
Dr Mancia said the difference between the US and European guidelines was that in calling some pressures “prehypertension,” the American guidelines tended to result in patients becoming anxious and led to intrusive lifestyle changes, medical visits, and laboratory tests. Dr Mancia suggested that the concept of prehypertension represented a certain way of looking at things, similar to the idea that the whole of life was a “pre-death experience.”
Dr David Lackland, professor of medicine at the University of South Carolina in Charleston, described the programme of the society's regional chapter for implementing the US guidelines in the “stroke belt” of North and South Carolina and Georgia, where rates of stroke, heart attack, and end stage renal disease are high.
Dr Daniel Levy of Framingham, Massachusetts, said there were barriers to implementing goals. Although 69% of hypertensive patients in the United States are aware of their disorder—compared with only 36% in the United Kingdom—control was still poor.
“The problem is systolic blood pressure in older patients who have older physicians,” he said.
FAQs
The European guidelines say optimal blood pressure is below 120/80 mm Hg; normal blood pressure is 120-129 mm Hg systolic and 80-84 mm Hg diastolic; and “high normal” is 130-139 mm Hg systolic and 85-89 mm Hg diastolic.
What is the difference between American and European blood pressure? ›
In the European guidelines, hypertension is defined as a BP ≥140/90 mm Hg (Table 1) while the Americans choose a lower threshold of BP ≥130/80 mm Hg. American guidelines classify Stage 1 hypertension as SBP ≥130‐139 mm Hg or DBP ≥80‐89 mm Hg while the Europeans define this as high normal BP (130-139/85-89 mm Hg).
What is the status of hypertension in Europe? ›
22% of people in the EU have high blood pressure - Products Eurostat News. The persistent effect of high blood pressure in arteries may lead to the chronic failure of vital organs such as the heart, kidneys or brain. In 2019, 22% of people in the EU aged 15 years and over reported having high blood pressure.
Did Europe change BP baseline to 140-90? ›
One of the most important novelties was the change in the definition of HTN by the American guidelines to a blood pressure ≥130/80 mm Hg. The European guidelines, however, maintained the same classification of BP categories and kept the definition of HTN at 140/90 mm Hg and above.
What are the American guidelines for hypertension treatment? ›
Recommendations and Key Points
First, the AAFP recommends that clinicians treat adults with hypertension to a standard blood pressure target of less than 140/90 mm Hg to reduce the risk of all-cause mortality and cardiovascular mortality. This is a strong recommendation based on high-quality evidence.
What are the international standards for hypertension? ›
In accordance with most major guidelines it is rec- ommended that hypertension be diagnosed when a person's systolic blood pressure (SBP) in the office or clinic is ≥140 mm Hg and/or their diastolic blood pressure (DBP) is ≥90 mm Hg following repeated examination (see below, Section 3).
Which country has the highest rate of hypertension in the world? ›
The researchers found that Canada, Peru and Switzerland had among the lowest prevalence of hypertension in the world in 2019, while some of the highest rates were seen in the Dominican Republic, Jamaica and Paraguay for women and Hungary, Paraguay and Poland for men.
What is high blood pressure called in USA? ›
High blood pressure – also known as hypertension – is a disease in which blood flows through blood vessels (arteries) at a higher-than-normal pressure.
What nationality has the lowest blood pressure? ›
The lowest rates of high blood pressure in the world are in Canada, the UK, Australia, the USA, Peru, South Korea and Singapore.
What is the European Society of hypertension 2024? ›
Cardiovascular Renal Protection (ESH 2024), which will be held in Berlin at the Estrel Congress Centre (ECC), on May 31-June 3, 2024. The 2024 Berlin Meeting will present the ESH conference in a new and fresh format with a streamlined range of session types.
Nearly half of adults have hypertension (119.9 million). About 1 in 4 adults with hypertension have their hypertension under control (27.0 million). All adults with hypertension are recommended by a clinician to undergo lifestyle modifications. This is the only treatment recommendation for 1 in 5 adults (25.0 million).
What is the blood pressure units in Europe? ›
This is why in Western Europe the SI-compliant unit bar is the most widely used unit. In contrast, in Australia and China the units “kilo-Pascal (kPa)” and “mega-Pascal (MPa)” have become established. In North America, the preferred pressure unit is “psi (pounds per square inch)”.
What is the European high blood pressure guidelines? ›
The 2023 ESH guidelines maintain the same BP grade classifications as the 2018 ESC/ESH guidelines. The ESH recommends a threshold of >140/90 mm Hg (grade 1) for the diagnosis of hypertension, whereas the ACC/AHA guideline recommends a lower threshold of >130/80 mm Hg (stage 1).
What is the difference between blood pressure in Europe and the US? ›
In summary, the main differences between ACC/AHA and ESC/ESH guidelines derive from the new definition of hypertension stated in the US with values ≥ 130/80 mmHg, while European guidelines retain the classical threshold of 140/90 mmHg.
Is 140 90 normal BP for seniors? ›
Blood pressure guidelines for men and women over 65
The American College of Cardiology (ACC) and the American Heart Association (AHA) currently recommend that men and women 65 and older aim for a blood pressure lower than 140/90 mm Hg.
What is the blood pressure guideline in France? ›
The French guideline recommends that the target blood pressure remains at < 140/90 mmHg, with < 150 mmHg for patients aged > 80 years. Systolic blood pressure between 130 and 139 mmHg and diastolic blood pressure < 90 mmHg are recommended for diabetic patients and those with chronic kidney disease.
What are the World health Organization guidelines on hypertension? ›
Blood pressure goal is less than 130/80 if you have: cardiovascular disease (heart disease or stroke) diabetes (high blood sugar) chronic kidney disease.
What are the new standards for blood pressure? ›
Blood pressure categories in the new guidelines are: Normal: 120/80 mm Hg or lower. Elevated: This used to be called “prehypertension.” The top number (systolic) is between 120 and 129 and the bottom number (diastolic) is 80 or lower. Elevated blood pressure can turn into high blood pressure if no action is taken.
What is considered normal blood pressure in Germany? ›
Therefore only a blood pressure of under 120/80 mmHg is considered optimal whilst the range between 120/80 mHg to below 140/90 mmHg is subdivided in the European guidelines into "normal" and "high-normal".
