geoffrey modest medical blogs

  Since I am on the track of hypertension now, I will report on a recent study finding that intensive blood pressure control was beneficial in elderly persons, independent of cardiovascular risk (see  htn intensive control better indep of risk  in dropbox, or DOI: 10.1161/HYPERTENSIONAHA.125.25162).   Details : -- 8262 Chinese patients in the STEP trial (Strategy of Blood Pressure Intervention in Older Hypertensive Patients), a multicenter, open-label randomized controlled trial of adults aged 60-80yo who had systolic blood pressure of 140-190 mmHg or were taking antihypertensive medication. these individuals were stratified by tertiles of baseline 10-year cardiovascular risk, with the goal to assess benefit and harm, evaluating both the effect on primary cardiovascular outcomes and adverse events. Those who had had a prior stroke were excluded -- within each tertile, patients were randomized to intensive blood pressure control (SBP 110 to <130 mmHg) versus s...

  Two sets of new hypertension guidelines were developed recently, one by the European Society of Cardiology (ESC) in 2024; the other by the American College of Cardiology/American Heart Association in 2025 (the ESC guidelines predated the 2025 ACC/AHA guidelines). In the following, I will compare the 2024 ESC guidelines mostly to the 2017 ACC/AHA guidelines (see https://gmodestmedblogs.blogspot.com/2017/11/new-aha-hypertension-guidelines.html ), since the updated 2025 ACC/AHA guidelines added very few new recommendations.   ACC/AHA guidelines: see:  htn 2025 AHA guidelines JACC2025  in dropbox, or doi.org/10.1016/j.jacc2025.05.007 ESC guidelines: htn 2024 european guidelines HTN2025  in dropbox, or doi/suppl/10.1161/HYPERTENSIONAHA.124.24173.   -- here is the list of all of their summary points of "what is new" in the 2025 AHA/ACC guidelines' new and revised recommendations beyond the 2017 AHA/ACC guidelines (these new guidelines are quite l...