European Society of Hypertension (ESH) Hypertension Guidelines 2023

ESC recommends regular blood pressure screenings for individuals with obstructive sleep apnea, COPD, chronic inflammatory diseases, non-alcoholic fatty liver disease (NASH), chronic infections (including COVID-19), migraines, and depression

• The new hypertension guidelines, presented at the European Society of Hypertension (ESH) Congress in Milan (May 2023) provide important updates for the management of arterial hypertension.
• They emphasize the need for early detection and categorize hypertension into three stages based on associated organ damage. The guidelines introduce several new risk factors and comorbidities for hypertension, including sleep disorders (including obstructive sleep apnea), COPD, chronic inflammatory diseases, non-alcoholic fatty liver disease (NASH), chronic infections (including COVID-19), migraines, and depression
• Additionally, they highlight the impact of air pollution, pregnancy complications, early menopause, and gender-affirming hormone therapy on hypertension risk. The guidelines recommend regular blood pressure screenings for individuals with these conditions and emphasize the importance of risk assessment and individualized treatment.
• The guidelines now introduce a systematic staging of hypertension & also recommend evaluating kidney function (eGFR according to the CKD-EPI formula), The guidelines advocate a renal ultrasound, and determining albumin loss in spontaneous morning urine at the initial diagnosis of arterial hypertension.