Episode 355: 254. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension

2024 ESC guidelines propose a simple new BP categorization:

• Non-elevated: less than 120/70 mm Hg in the office (pharmacological treatment is not recommended).
• Elevated: 120 to 139/70 to 89 mm Hg (pharmacological treatment is recommended for some, depending on cardiovascular disease [CVD] risk and follow-up BP measurements).
• Hypertension: 140/90 mm Hg or greater (confirmation and prompt pharmacological treatment is recommended).

lifestyle interventions are particularly critical for individuals with an elevated BP but a low predicted risk of CVD. Adults in this group are common and account for up to one-third of all CVD events,

2024 ESC Guidelines provide two major new lifestyle approaches for managing elevated BP and hypertension.

first new option is potassium supplementation, either by dietary supplementation or potassium-enriched salt substitutes. The mechanistic and observational data supporting the benefits of potassium supplementation on BP are not new. However, recent CVD outcomes trials demonstrate the benefits of potassium supplementation where clinically appropriate. Potassium-enriched salts typically contain 75% sodium chloride and 25% potassium chloride, while dietary potassium sources include foods such as bananas (450 mg per medium-sized banana), unsalted boiled spinach (840 mg per cup), and mashed avocado (710 mg per cup)

The second new option is to increasingly understand the BP-lowering benefits of resistance exercise training.4 Not everyone can perform the aerobic exercises traditionally recommended in BP management guidelines, and resistance exercise offers an important alternative for both clinicians and patients.

ANY EXERCISE