Guideline-Driven Management of Hypertension: An Evidence-Based Update

Circ Res. 2021 Apr 2;128(7):827-846. doi: 10.1161/CIRCRESAHA.121.318083. Epub 2021 Apr 1.


Several important findings bearing on the prevention, detection, and management of hypertension have been reported since publication of the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline. This review summarizes and places in context the results of relevant observational studies, randomized clinical trials, and meta-analyses published between January 2018 and March 2021. Topics covered include blood pressure measurement, patient evaluation for secondary hypertension, cardiovascular disease risk assessment and blood pressure threshold for drug therapy, lifestyle and pharmacological management, treatment target blood pressure goal, management of hypertension in older adults, diabetes, chronic kidney disease, resistant hypertension, and optimization of care using patient, provider, and health system approaches. Presenting new information in each of these areas has the potential to increase hypertension awareness, treatment, and control which remain essential for the prevention of cardiovascular disease and mortality in the future.

Keywords: American Heart Association; antihypertensive agents; blood pressure; cardiovascular disease; hypertension; mortality.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Age Factors
  • Aged
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure / physiology
  • Blood Pressure Determination
  • Diabetes Mellitus / therapy
  • Drug Resistance
  • Heart Disease Risk Factors
  • Humans
  • Hyperaldosteronism / complications
  • Hypertension* / diagnosis
  • Hypertension* / etiology
  • Hypertension* / prevention & control
  • Hypertension* / therapy
  • Hypertension, Renovascular / therapy
  • Life Style
  • Meta-Analysis as Topic
  • Observational Studies as Topic
  • Randomized Controlled Trials as Topic
  • Renal Insufficiency, Chronic / therapy
  • Young Adult


  • Antihypertensive Agents