Hypertension
Also known as: elevated blood pressure · high blood pressure · HTN
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2025 AHA/ACC Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults
ACC/AHA (multisociety) · 2025
Supersedes the 2017 ACC/AHA (multisociety) version
The current US guideline on preventing, detecting, evaluating, and managing high blood pressure in adults. It is the first full revision since 2017.
2024 ESC Guidelines for the management of elevated blood pressure and hypertension
ESC (endorsed by ESE, ESO) · 2024
Supersedes the 2018 ESC/ESH version
The current European guideline. It was retitled from 'arterial hypertension' to 'elevated blood pressure and hypertension' to reflect a continuous relationship between blood pressure and cardiovascular risk.
- Adds an 'Elevated BP' category (120–139/70–89 mm Hg) between non-elevated BP and hypertension (≥140/90). source
- Recommends an on-treatment target of 120–129/70–79 mm Hg for most adults who tolerate it. source
- Gives a Class I emphasis to out-of-office BP measurement for both diagnosis and management. source
US vs EU key differences
- Diagnostic threshold differs: the US guideline labels hypertension at ≥130/80 mm Hg, while the ESC keeps the hypertension label at ≥140/90 and adds a separate 'Elevated BP' band (120–139/70–89). source
- Risk tool differs: the US guideline uses the new PREVENT equations; the ESC bases drug-treatment decisions in the elevated-BP range on cardiovascular risk (including SCORE2). source
- On-treatment targets are broadly aligned — <130/80 mm Hg (US) versus 120–129/70–79 mm Hg (ESC) for most adults. source
What changed recently
- US2017 → 20252025-06-15
First full US revision since 2017: adopts the PREVENT equations for risk estimation (replacing the Pooled Cohort Equations) and reaffirms a <130/80 mm Hg treatment goal.
- EU2018 → 20242024-06-15
Introduces a new 'Elevated BP' category (120–139/70–89 mm Hg) and a 120–129/70–79 mm Hg on-treatment target for most adults, with a Class I emphasis on out-of-office measurement.
See the full update feed for changes across every system.