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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EKey opinion leaders covered the 2013 updated European Society of Cardiology (ESC)\/European Society of Hypertension (ESH) Guidelines for the management of arterial hypertension, highlighting new aspects of diagnosis and treatment [Mancia G et al. \u003Cem\u003EEur Heart J 2013\u003C\/em\u003E]. These 2013 ESC\/ESH guidelines represent an update to those last published in 2007 [Mancia G et al. \u003Cem\u003EJ Hypertens 2007\u003C\/em\u003E], and although they reinforce and refine many pre-existing concepts, several new recommendations are included as well.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Guidelines\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHypertensive Disease\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology \u0026amp; Cardiovascular Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Guidelines\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHypertensive Disease\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EKey opinion leaders covered the 2013 updated European Society of Cardiology (ESC)\/European Society of Hypertension (ESH) Guidelines for the management of arterial hypertension, highlighting new aspects of diagnosis and treatment [Mancia G et al. \u003Cem\u003EEur Heart J\u003C\/em\u003E 2013]. These 2013 ESC\/ESH guidelines represent an update to those last published in 2007 [Mancia G et al. \u003Cem\u003EJ Hypertens\u003C\/em\u003E 2007], and although they reinforce and refine many pre-existing concepts, several new recommendations are included as well.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EJosep Redon, MD, PhD, University of Valencia, Spain, discussed new aspects in diagnosis of hypertension in the guidelines, emphasizing the increased consideration of hypertension in association with combined cardiovascular (CV) and other risk factors, such as diabetes and organ damage. The guidelines also include an increasing role for out-of-office blood pressure (BP) monitoring, especially when there is discordance between in-clinic and ambulatory BP measurements. Specific recommendations for special patient populations such as pregnant women, young patients, and the elderly, also are provided.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EAccording to Robert H. Fagard, MD, PhD, Katholieke Universiteit, Leuven, Belgium, the guidelines encourage physicians to initiate antihypertensive strategies considering the patient\u0027s level of CV risk. They also recommend treating all patients aged \u0026lt;80 years to systolic BP (SBP) \u0026lt;140 mm Hg. For patients aged \u0026gt;80 years with SBP \u2265160 mm Hg, the recommended SBP target is 140 to 150 mm Hg. Lifestyle changes are still recommended for all patients to help lower BP, including reducing salt intake to 5 to 6 g per day, and reducing weight to a body mass index of 25 kg\/m\u003Csup\u003E2.\u003C\/sup\u003E\n      \u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003ESverre E. Kjeldsen, MD, PhD, University of Oslo, Ullevaal Hospital, Oslo, Norway summarized the recommended treatment algorithm. The updated guidelines indicate no preference for specific agents in uncomplicated hypertension, so all typical first-line drugs can be used. For patients requiring more than one drug, combinations of thiazide diuretics, calcium channel blockers, angiotensin receptor blockers, and angiotensin-converting-enzyme inhibitors is advised. Dual renin-angiotensin-aldosterone system blockade is no longer recommended, and diltiazem and verapamil should not be combined with a \u03b2-blocker. However, \u03b2-blockers remain the cornerstone of therapy for patients with heart failure, coronary disease, and tachyarrhythmias (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/15\/9\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u00222013 Drug Combinations for the Treatment of Hypertension\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-759289599\u0022 data-figure-caption=\u00222013 Drug Combinations for the Treatment of Hypertension\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/15\/9\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/15\/9\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/15\/9\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/13706\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003E2013 Drug Combinations for the Treatment of Hypertension\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EACE=angiotensin-converting enzyme.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EMancia G et al. 2013 ESH\/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). \u003Cem\u003EEur Heart J\u003C\/em\u003E 2013;34(28):2159\u20132219. With permission from Oxford University Press.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EGiuseppe Mancia, MD, University of Milano-Bicocca, Milan, Italy, summarized clinical trials demonstrating the protective effect of reducing BP below 140\/90 mm Hg. The International Verapamil SR Trandolapril Study [INVEST], for example, was designed to evaluate whether study outcomes are related to consistency of BP control below this target [Mancia G et al. \u003Cem\u003EHypertension\u003C\/em\u003E 2007]. In 22,576 patients with hypertension and coronary artery disease, as the number of visits where BP was 140\/90 mm Hg increased, fewer CV events occurred. A similar association was also demonstrated by the Ongoing Telmisartan Alone and in Combination With Ramipril Global End Point Trial [ON TARGET; Mancia G et al. \u003Cem\u003ECirculation\u003C\/em\u003E 2011].\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EProf. Mancia concluded, however, that there is no evidence from randomized trials of an additional beneficial effect of more aggressive therapy to reduce SBP below 130 mm Hg [Barzilay JI et al. \u003Cem\u003EDiabetes Care\u003C\/em\u003E 2012; Appel LJ et al. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2010; Ruggenenti P et al. \u003Cem\u003ELancet\u003C\/em\u003E2005; Beri T et al. \u003Cem\u003EAnn Intern Med\u003C\/em\u003E 2003].\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2013 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/13\/15\/9.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nznmm2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nznmm2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}