New Hypertension Guidelines: Progression or a Step Backwards in Hypertension?

In the last years, many hypertension guidelines have been published as new or revised versions. They follow the general trend that only clinical evidence is relevant for guidelines. Expert opinion is downplayed. At present, guidelines from three major organizations have been produced: by the European Society of Hypertension, the International Society/American Society of Hypertension, and the US Joint National Committee. We discuss eight versions of these guidelines in this review. All of these include statements on blood pressure goals or treatment algorithms for patients with high blood pressure. The variability of practical tips is great, and the recommendations, which mainly rely on evidence-based medical information, show slight differences that have resulted in some confusion with specialists and also practitioners. In the current review, the changes in the guidelines in comparison to previous guidelines are discussed, and reasons for different recommendations are explained. The hope is to reduce confusion.