[Management of elevated blood pressure and hypertension : Focus on risk reduction].

Authors

Raphael S Schmieder, Heribert Schunkert

Published in

Herz. Jul 24, 2026. Epub Jul 24, 2026.

Abstract

The 2024 hypertension guidelines from the European Society of Cardiology (ESC) introduce the category of 'elevated blood pressure' (120-139/70-89 mm Hg) and emphasise the importance of early prevention in individuals with such blood pressure levels and comorbid conditions. As blood pressure is recognised as a continuous risk factor, early initiation of antihypertensive treatment may be recommended even below the hypertensive range, depending on overall cardiovascular risk. All affected individuals should adopt a healthy lifestyle: regular exercise, balanced diet, reduced alcohol and salt intake, weight loss, and smoking cessation. If blood pressure remains > 130/80 mm Hg after three months and the patient has cardiovascular disease, heart failure, or a moderate to high risk, pharmacotherapy is advised. At ≥ 140/90 mm Hg, lifestyle measures and low-dose dual combination therapy should be initiated concurrently. The target systolic blood pressure is 120-129 mm Hg, with exceptions for individuals with frailty or those aged > 85 years. For resistant hypertension, spironolactone is the recommended pharmacological therapy, while renal denervation is listed as an interventional option.

PMID:
42496874
Bibliographic data and abstract were imported from PubMed on 24 Jul 2026.

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