According to latest statistical report[1], over 75% of the population aged at least 40 years has elevated blood pressure (BP) levels (and more than 80% among those aged >59 years). Furthermore, only 60% of patients achieve good BP control, and despite the decreasing cardiovascular (CV) morbidity, BP is still a leading cause of death in Western countries, affecting nearly 230 of every 100.000 individuals.
In addition, the annual direct and indirect cost of CV diseases in the United States is an estimated US$ 320.1 billion, including US$ 195.6 billion in expenditures (direct costs, such as the cost of physicians and other professionals, hospital services, prescribed medication, and home health care) and US$ 124.5 billion in lost future productivity attributed to premature CV disease and stroke mortality (indirect costs).
Hypertension is one of the leading risk factors for ischemic heart disease, stroke, heart failure, and renal dysfunction[2]. Thus, management of hypertension should be targeted not only for BP control but also for the reduction of overall cardiovascular and renal morbidity and mortality; hence in these settings, risk stratification and multidisciplinary approach aiming to a patient-tailored treatment strategy represent the keys to clinical success[3].
As outlined in the latest guidelines3,[4], CV risk stratification needs to be refined beyond risk models available, which don’t include non-traditional CV disease risk modifiers, such as hormonal alterations, pregnancy complications, socio-economic deprivation, auto-immune inflammatory diseases, and mental illness.
Consequently, an appropriate therapeutic strategy, in addition to blood pressure reduction, should include a pathophysiological multidisciplinary approach to carefully assess individual CV risk and to implement a care and support plan considering the specific needs of each patient. In addition, patient education still represents the cornerstone to improve adherence to treatment.
[1] Martin SS, et al. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation. 2024; 149:e347-e913.
[2] Centers for Disease Control and Prevention. High Blood Pressure Facts. Atlanta, GA: Centers for Disease Control and Prevention; 2025. Available from: https://www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html, 28 Jan 2025.
[3] McEvoy JW, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024:45:3912-4018.
[4] Mancia G, et al. 2023 ESH Guidelines for the management of arterial hypertension. J Hypertens. 2023;41:1874-2071.
