Latest hypertension guidelines target elevated blood pressure and heart attack prevention

John William (Bill) McEvoy MB BCh BAO, MEd, MHS, PhD, FRCPI

Medical and Research Director, National Institute for Prevention and Cardiovascular Health
Established Professor of Preventive Cardiology, School of Medicine, University of Galway, Ireland.
Consultant Cardiologist, University College Hospital Galway, Saolta Healthcare Group.

The European Society of Cardiology (ESC) has released updated guidelines for managing high blood pressure, aiming to significantly impact heart health across Europe.

Recent guidelines for managing high blood pressure

Co-chaired by Professor Bill McEvoy, Professor of Preventive Cardiology at University of Galway and Medical and Research Director of the National Institute for Preventive Cardiology (NIPC), these guidelines introduce more intensive treatment targets and a new ‘elevated blood-pressure’ category to help prevent heart attacks and strokes.

Hypertension is a leading cause of cardiovascular disease, affecting about 45% of European adults. The new ESC guidelines introduce an ‘Elevated BP’ category for blood pressures between 120–139/70-89 mmHg, allowing earlier intervention for those at risk. This change recognises that blood pressure rises gradually and certain groups, such as people with diabetes, could benefit from more intensive treatment before reaching the traditional hypertension threshold.

INTERASPIRE study highlights the real-world challenge: 61% of heart disease patients globally do not have controlled blood pressure.

Target systolic levels and rise of home monitoring

The guidelines now recommend a target systolic blood pressure of 120–129 mmHg for most patients on medication, shifting from prior, less aggressive approaches. This change is driven by evidence showing that more intensive targets can better reduce cardiovascular risks. Another major recommendation is the increased use of home and ambulatory blood pressure monitors, helping patients and doctors make more informed decisions based on accurate, real-world data.

Bridging evidence-based guidelines and real-world outcomes

Professor McEvoy’s leadership extends beyond the guidelines, as his work with the INTERASPIRE study highlights the real-world challenge: 61% of heart disease patients globally do not have controlled blood pressure. This connection between evidence-based guidelines and real-world outcomes underscores the importance of the new ESC guidelines.

Professor McEvoy is a unique and pioneering medic, a practising consultant preventive cardiologist and an academic clinician at University of Galway. He also leads research and its implementation through to clinical practice at the NIPC.

National initiative to improve cardiovascular health in Ireland

As an independent medical research and education institute, NIPC is dedicated to advancing cardiovascular health through a strong focus on prevention, education and research. Working in collaboration with key stakeholders, its primary objective is to reduce the burden of cardiovascular disease.

Professor McEvoy will launch NIPC’s latest ‘Irish Hearts’ research project, a national population study, in partnership with Croí, the heart and stroke charity and the University of Galway at this year’s Heartfest event (September 25–27, 2024). This research study aims to gather critical information on heart health in Ireland, where individuals from the general population will be randomly selected for cardiovascular screening. This initiative is designed to contribute to heart and stroke prevention research, helping to enhance public health strategies across the country.