2018 ESC/ESH Guidelines for the Management of Arterial Hypertension

Williams, Bryan; Mancia, Giuseppe; Spiering, Wilko; Rosei, Enrico Agabiti; Azizi, Michel; Burnier, Michel; Clément, Denis; Coca, António; Simone, Giovanni de; Dominiczak, Anna F.; Kahan, Thomas; Mahfoud, Felix; Redón, Josep; Ruilope, Luis; Zanchetti, Alberto; Kerins, Mary; Kjeldsen, Sverre E.; Kreutz, Reinhold; Laurent, Stéphane; Lip, Gregory Y.H.; McManus, Richard J; Ruschitzka, Frank; Schmieder, Roland E.; Shlyakhto, Evgeny; Tsioufis, Κonstantinos; Aboyans, Victor; Desormais, Iléana

doi:10.1201/9780429199189-75

Cited by 107 publications

(132 citation statements)

References 484 publications

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“…The hypertensive emergencies require immediate intervention to lower blood pressure [29]. It is important to reduce the blood pressure in appropriate pace, which is~20-25% decrease within several hours [30].…”

Section: Treatmentmentioning

confidence: 99%

“…They constitute various clinical presentations of the same disease entity [2,3]. The current 2018 ESC/ESH Guidelines for the management of arterial hypertension present new, broadened approach to the hypertensive emergencies [29]. A collective group of "hypertension urgencies and emergencies" was distinguished with a strong emphasis on magnitude of organ damage, described as hypertension-mediated organ damage [29].…”

Section: New Definitionmentioning

confidence: 99%

“…The current 2018 ESC/ESH Guidelines for the management of arterial hypertension present new, broadened approach to the hypertensive emergencies [29]. A collective group of "hypertension urgencies and emergencies" was distinguished with a strong emphasis on magnitude of organ damage, described as hypertension-mediated organ damage [29]. Besides, the term of "malignant hypertension" was clarified as it refers to the poor prognosis when untreated [29].…”

Section: New Definitionmentioning

confidence: 99%

“…A collective group of "hypertension urgencies and emergencies" was distinguished with a strong emphasis on magnitude of organ damage, described as hypertension-mediated organ damage [29]. Besides, the term of "malignant hypertension" was clarified as it refers to the poor prognosis when untreated [29]. It characterizes the condition of severe hypertension with concomitant retinopathy, microangiopathy, disseminated intravascular coagulation, encephalopathy, acute heart failure, or acute deterioration in renal function [29].…”

Section: New Definitionmentioning

confidence: 99%

“…Besides, the term of "malignant hypertension" was clarified as it refers to the poor prognosis when untreated [29]. It characterizes the condition of severe hypertension with concomitant retinopathy, microangiopathy, disseminated intravascular coagulation, encephalopathy, acute heart failure, or acute deterioration in renal function [29]. Updated guidelines also offer greater range of diagnostic possibilities depending on target organs affected and symptoms, divided on common and specific tests [29].…”

Section: New Definitionmentioning

confidence: 99%

See 4 more Smart Citations

Malignant hypertension: does this still exist?

et al. 2019

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Section: Treatmentmentioning

confidence: 99%

Section: New Definitionmentioning

confidence: 99%

Section: New Definitionmentioning

confidence: 99%

Section: New Definitionmentioning

confidence: 99%

Section: New Definitionmentioning

confidence: 99%

See 3 more Smart Citations

Malignant hypertension: does this still exist?

et al. 2019

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Comparative analysis of intracardiac neural structures in the aged rats with essential hypertension

Pauziene

Ranceviene

Rysevaitė-Kyguolienė

et al. 2022

The Anatomical Record

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Persistent arterial hypertension initiates cardiac autonomic imbalance and alters cardiac tissues. Previous studies have shown that neural component contributes to arterial hypertension etiology, maintenance, and progression and leads to brain damage, peripheral neuropathy, and remodeling of intrinsic cardiac neural plexus. Recently, significant structural changes of the intracardiac neural plexus were demonstrated in young prehypertensive and adult hypertensive spontaneously hypertensive rats (SHR), yet structural alterations of intracardiac neural plexus that occur in the aged SHR remain undetermined. Thus, we analyzed the impact of uncontrolled arterial hypertension in old (48–52 weeks) SHR and the age‐matched Wistar‐Kyoto rats (WKY). Intrinsic cardiac neural plexus was examined using a combination of immunofluorescence confocal microscopy and transmission electron microscopy in cardiac sections and whole‐mount preparations. Our findings demonstrate that structural changes of intrinsic cardiac neural plexus caused by arterial hypertension are heterogeneous and may support recent physiological implications about cardiac denervation occurring together with the hyperinnervation of the SHR heart. We conclude that arterial hypertension leads to (i) the decrease of the neuronal body area, the thickness of atrial nerves, the number of myelinated nerve fibers, unmyelinated axon area and cumulative axon area in the nerve, and the density of myocardial nerve fibers, and (ii) the increase in myelinated nerve fiber area and density of neuronal bodies within epicardiac ganglia. Despite neuropathic alterations of myelinated fibers were exposed within intracardiac nerves of both groups, SHR and WKY, we consider that the determined significant changes in structure of intrinsic cardiac neural plexus were predisposed by arterial hypertension.

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The relationship between isolated hypertension with brain volumes in UK Biobank

et al. 2022

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Background: Hypertension is a well-established risk factor for cognitive impairment, brain atrophy, and dementia. However, the relationship of other types of hypertensions, such as isolated hypertension on brain health and its comparison to systolicdiastolic hypertension (where systolic and diastolic measures are high), is still relatively unknown. Due to its increased prevalence, it is important to investigate the impact of isolated hypertension to help understand its potential impact on cognitive decline and future dementia risk. In this study, we compared a variety of global brain measures between participants with isolated hypertension to those with normal blood pressure (BP) or systolic-diastolic hypertension using the largest cohort of healthy individuals.Methods: Using the UK Biobank cohort, we carried out a cross-sectional study using 29,775 participants (mean age 63 years, 53% female) with BP measurements and brain magnetic resonance imaging (MRI) data. We used linear regression models adjusted for multiple confounders to compare a variety of global, subcortical, and white matter brain measures. We compared participants with either isolated systolic or diastolic hypertension with normotensives and then with participants with systolic-diastolic hypertension. Results:The results showed that participants with isolated systolic or diastolic hypertension taking BP medications had smaller gray matter but larger white matter microstructures and macrostructures compared to normotensives. Isolated systolic hypertensives had larger total gray matter and smaller white matter traits when comparing these regions with participants with systolic-diastolic hypertension.Conclusions: These results provide support to investigate possible preventative strategies that target isolated hypertension as well as systolic-diastolic hypertension to maintain brain health and/or reduce dementia risk earlier in life particularly in white matter regions.

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2018 ESC/ESH Guidelines for the Management of Arterial Hypertension

Cited by 107 publications

References 484 publications

Malignant hypertension: does this still exist?

Malignant hypertension: does this still exist?

Comparative analysis of intracardiac neural structures in the aged rats with essential hypertension

The relationship between isolated hypertension with brain volumes in UK Biobank

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