Blood pressure · 2026
A consensus statement from the Portuguese Society of Hypertension and the Portuguese Society of Cardiology for bridging the 2023-2025 hypertension Guidelines in clinical practice.
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Ribeiro Heloísa, Matos Vilela Eduardo, Martos Gonçalves Fernando, Gavina Cristina, de Pinho Rosa
Аннотация
BACKGROUND: Effective management of arterial hypertension remains a major global health priority. In the need to improve real-world implementation of best practices, three international organisations have released independent clinical practice guidelines: the European Society of Hypertension (ESH, 2023), the European Society of Cardiology (ESC, 2024) and the American College of Cardiology/American Heart Association (AHA/ACC, 2025).1.
AIM AND METHODS: This society-endorsed consensus document, jointly developed by the Portuguese Society of Hypertension and the Portuguese Society of Cardiology, aims to harmonise partially divergent hypertension guidelines into applicable recommendations. It provides a pragmatic comparative synthesis of the 2023-2025 guidelines, structured according to the M.A.P.E. framework (Measure, Assess, Prescribe, Evaluate), to support decision-making in clinical practice.
RESULTS: Across European guidelines, there is a strong alignment in the definition of hypertension (systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg), CV risk stratification, lifestyle interventions, and first-line use of combination therapy of two drugs out of four. Divergences arise in BP classification systems, initiation thresholds, dosing strategies and target BP goals. The 2025 AHA/ACC Guidelines differ by adopting lower diagnostic and treatment thresholds (≥130/80 mmHg) and early pharmacological intervention based on individual CV risk. This consensus acknowledges differences and supports a risk-based approach grounded in randomised trial evidence, feasibility in routine clinical practice, and patient safety, recognising office BP as the basis for treatment decisions.
CONCLUSIONS: This consensus aims to reduce clinical uncertainty and optimise hypertension management in real-world practice providing clear and evidence-informed clinical recommendations.
AIM AND METHODS: This society-endorsed consensus document, jointly developed by the Portuguese Society of Hypertension and the Portuguese Society of Cardiology, aims to harmonise partially divergent hypertension guidelines into applicable recommendations. It provides a pragmatic comparative synthesis of the 2023-2025 guidelines, structured according to the M.A.P.E. framework (Measure, Assess, Prescribe, Evaluate), to support decision-making in clinical practice.
RESULTS: Across European guidelines, there is a strong alignment in the definition of hypertension (systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg), CV risk stratification, lifestyle interventions, and first-line use of combination therapy of two drugs out of four. Divergences arise in BP classification systems, initiation thresholds, dosing strategies and target BP goals. The 2025 AHA/ACC Guidelines differ by adopting lower diagnostic and treatment thresholds (≥130/80 mmHg) and early pharmacological intervention based on individual CV risk. This consensus acknowledges differences and supports a risk-based approach grounded in randomised trial evidence, feasibility in routine clinical practice, and patient safety, recognising office BP as the basis for treatment decisions.
CONCLUSIONS: This consensus aims to reduce clinical uncertainty and optimise hypertension management in real-world practice providing clear and evidence-informed clinical recommendations.