The Impact of the 2024 ESC Guidelines for the Management of Elevated Blood Pressure and Hypertension on a Population Sample with a Mean Age of 59 Years

Abstract

Introduction: Hypertension is a challenge for the global healthcare system due to its high prevalence and importance as a risk factor for the development of cardiovascular disease (CVD) and premature death. Its control remains unsatisfactory, despite the proven efficacy and good tolerance of pharmacological treatment. Clinical practice guidelines are extremely important for guiding the management of these patients. The 2024 European Society of Cardiology (ESC) guideline classified blood pressure (BP) ≥ 120/70 and < 140/90 mmHg as elevated BP, indicating approach, and established a BP < 130/80 mmHg as the therapeutic target. Objective: To evaluate the impact of the 2024 ESC Guidelines (ESC-2024) on blood pressure control rates and the prevalence of individuals requiring approach in a population sample, through a comparative analysis with the 2018 ESC Guidelines (ESC-2018). Methods: This was a cross-sectional study involving adults aged ≥ 18 years. Sociodemographic data, history of cardiometabolic diseases, cardiovascular risk factors, anthropometric data, and BP were collected. The results were expressed as percentages, and comparisons were made using the McNemar test. Results: 504 individuals were evaluated, with a mean age of 59.56 years; 50.59% were men, 40.68% obese, 21.63% diabetic, and 49.21% had a history of hypertension (HH). Under the ESC-2024 criteria, the therapeutic target was reached in 11.70% of hypertensive patients, a percentage 3.48 times lower than that observed when the ESC-2018 criteria were applied (P<0.001). According to the ESC-2024 recommendations, 59.38% of individuals without HH had an indication for approach, a percentage 5 times higher than that obtained under the ESC-2018 criteria, characterizing a significant difference (P<0.001). Conclusion: In this population sample, ESC-2024 had a significant impact on hypertension control rates and the prevalence of individuals with indications for approaches, which reinforces the need to adopt evidence-based criteria in our clinical practice and discourages therapeutic inertia.