A comprehensive overview of the diagnosis and treatment of hypertension based on the latest hypertension guidelines

Abstract

In recent years, non-communicable diseases (NCDs) have accounted for about 70% of the world's deaths. The most common NCDs are cardiovascular disease, cancer, diabetes mellitus, and chronic respiratory diseases. These diseases have four common risk factors, including inadequate physical activity, unhealthy diet, smoking, and excessive alcohol consumption. Cardiovascular diseases, despite their high prevalence, are the most preventable chronic diseases. The most common risk factor for cardiovascular disease is high blood pressure, which can be prevented if it is diagnosed and controlled carefully. Recent guidelines have changed the methods of blood pressure measurement, definition, and treatments. Recently, more emphasis has been placed on Out-of-Office Blood Pressure Measurement. Therefore, it is necessary to consider the methods of measuring blood pressure at home and 24-hour Holter blood pressure monitoring, as well as understanding its standards. The use of automatic arm sphygmomanometers to measure blood pressure is more acceptable than manual ones (mercury or Aneroid). The most accepted definitions of hypertension are BP≥140/90 mm Hg in the clinic, the average blood pressure at home≥135/85 mm Hg, and the average blood pressure in 24-hour Holter monitoring≥130/80 mm Hg. Proper treatment of hypertension by changing lifestyle and proper medication therapy can control blood pressure and prevent serious complications. Today, the use of combination drugs, especially a single pill in a single dose, has been emphasized. This study aimed to review the most recent hypertension treatment protocols based on the guidelines of the American Heart Association (AHA 2017), the European Society of Cardiology (ESC 2018), the British Heart Association (NICE 2019), and the International Society of Hypertension (ISH 2020). Furthermore, this study attempted to assess the symptoms, complications, methods of diagnosing, definitions, as well as pharmacological and non-pharmacological treatments of hypertension.