LA GESTIONE DEL PAZIENTE IPERTESO NELLA PRATICA CLINICA ALLA LUCE DELLE PIÙ RECENTI LINEE GUIDA AMERICANE SUL TRATTAMENTO DELL’IPERTENSIONE ARTERIOSA IN CONFRONTO CON LE LINEE GUIDA EUROPEE

In 2017, the American Heart Association, in collaboration with the American College of Cardiology, published the new edition of the guidelines on the management of patients suffering from high blood pressure. Compared to previous editions, this document proposes updates on recommendations based on classes and levels of evidence and derived from the most recent evidence provided by important randomized trials and observational studies. Some of the propositions and recommendations provided by this edition differ profoundly from the most recent European guidelines of 2018. In particular, the American guidelines define arterial pressure values as normal <120/80 mmHg, while the threshold for the diagnosis of arterial hypertension is now indicated for arterial pressure values ≥130 / 80mmHg. Furthermore, incorporating data from the Systolic Intervention Blood Pressure Trial, the guidelines recommend a new more “aggressive” pressure target (<130 / 80mmHg) to be achieved with anti-hypertensive treatment in most patients, regardless of age. The European guidelines instead confirm the definition of hypertension for values ≥140/90 mmHg, with differentiated targets in relation to the type and age of the patients, suggesting however to reach values not lower than 120/70 mmHg. This review aims to address the most innovative aspects of the guidelines proposed by the American Heart Association in collaboration with the American College of Cardiology, also in order to provide meaningful comparative data with those issued in 2018 by the European Hypertension Society in collaboration with the European Society of Cardiology.