This opens the door to differing interpretations of the literature, said Mancia.Ĭalling out the areas of agreement will enable the field to better tackle hypertension, said Whelton. Moreover, not all of the evidence for guidelines comes from randomized controlled trials, with some advice being informed by experience and less-rigorous studies. “So the accent is placed on differences, but if you look at the similarities, these are much more important.” When everybody agrees, there’s no research anymore, in a way,” he commented to TCTMD. For them, that’s what’s “more interesting. Giuseppe Mancia, MD (University of Milano-Bicocca, Milan, Italy), ESH chairperson for the 2018 European guidelines and a coauthor of the new paper, said that investigators conducting scientific research are often drawn to differences. Even in the area of greatest discord, which is classification of blood pressure, when it came to actual management, we were very similar.” In this case, efforts by some to “stir the pot” are also inaccurate, he continued, “because the vast majority of what we were recommending was very similar. We’ll just continue doing what we’ve always done.’” “It sows the seeds of people saying: ‘Well, we don’t know what to do. That can limit the impact of the new recommendations, he said. “The first thing people usually do with guidelines, and it’s kind of a knee-jerk response, is to put them side by side and what can we find that’s different and then make an awful lot out of that: ‘The experts can’t agree. “We were very enthusiastic” about the opportunity to explore where the documents converge, Whelton told TCTMD. Whelton, MD (Tulane University School of Public Health and Tropical Medicine, New Orleans, LA), president-elect of the World Hypertension League and writing group chair for the US recommendations. The new paper was commissioned by the US and European societies to compare and contrast the two guidelines, said lead author Paul K. Just a year later, in 2018, the European Society of Cardiology/European Society of Hypertension (ESC/ESH) released their own guidance. Their article, published recently in Circulation, makes the case for “harmonization” as a way forward.īack in 2017, the American College of Cardiology/American Heart Association (ACC/AHA) issued recommendations for the prevention, detection, evaluation, and management of high blood pressure. (UPDATED) Leading hypertension experts on both sides of the Atlantic say there is more in common between their two sets of guidelines than there are things that set them apart.
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