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[Novelties in the European Hypertension Guide 2007. European Society of Cardiology. European Society of Hypertension].

The 2007 European Guidelines on Hypertension are jointly sponsored by the European Society of Cardiology and the European Society of Hypertension. Changes with respect to the previous 2003 Guidelines are few but some are significant. Perhaps the most significant change is inclusion of metabolic syndrome as a cardiovascular risk factor similar in importance to diabetes mellitus or target-organ damage. Also striking is the recognition of chronic kidney disease as a very high risk condition in hypertensive patients. Masked arterial hypertension (AHT) is included for the first time as a new entity that is present in 10-15% of cases and associated with increased cardiovascular risk. The eye fundus examination is no longer considered necessary in the diagnostic evaluation. The decision to start treatment should be based on systolic and diastolic BP values and on assessment of total cardiovascular risk. Drug therapy should be started early. The delay to check the response to nonpharmacological measures should be only some weeks and not months as was previously established. Any of the five large groups (diuretics, beta-blockers, calcium antagonists, ACE inhibitors and angiotensin II blockers) is valid for the first stage of treatment, although the choice should be individualized based on the possible risk factors and associated cardiovascular and renal disease. The guidelines place strong emphasis on drug combinations because most patients will require more than one drug for their control.