This study compares the recommendations of the most recent American College of Cardiology (ACC)/American Heart Association (AHA) and European Society of Cardiology (ESC)/European Society of Hypertension (ESH) blood pressure guidelines. Both guidelines represent updates of previous guidelines and reinforce previous concepts of prevention regarding elevated blood pressure. Specifically, a low-sodium diet, exercise, body weight reduction, low to moderate alcohol intake, and adequate potassium intake are emphasized. Overall, both guidelines agree on the proper method of blood pressure measurement, the use of home blood pressure and ambulatory monitoring, and restricted use of beta-blockers as first-line therapy. The major disagreements are with the level of blood pressure defining hypertension, flexibility in identifying blood pressure targets for treatment, and the use of initial combination therapy. Although initial single-pill combination therapy is strongly recommended in both guidelines, the ESC/ESH guideline recommends it as initial therapy in patients at ≥140/90 mm Hg. The ACC/AHA guideline recommends its use in patients >20/10 mm Hg above blood pressure goal. Thus, the only real disagreement is that the ACC/AHA guidelines maintain that all people with blood pressure >130/80 mm Hg have hypertension, and blood pressure should be lowered to <130/80 mm Hg in all. In contrast, the ESC/ESH guidelines state that hypertension is defined as >140/90 mm Hg, with the goal being a level <140/90 mm Hg for all targeting to <130/80 mm Hg only in those at high cardiovascular risk, but always considering individual tolerability of the proposed goal.

中文翻译：

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ACC/AHA 与 ESC/ESH 的高血压指南

本研究比较了最新的美国心脏病学会 (ACC)/美国心脏协会 (AHA) 和欧洲心脏病学会 (ESC)/欧洲高血压学会 (ESH) 血压指南的建议。这两个指南都代表了先前指南的更新，并强化了先前有关高血压的预防概念。具体而言，强调低钠饮食、运动、减轻体重、低至中等酒精摄入量和充足的钾摄入量。总体而言，两个指南都同意正确的血压测量方法、使用家庭血压和动态监测以及限制使用 β 受体阻滞剂作为一线治疗。主要分歧在于定义高血压的血压水平，确定治疗血压目标的灵活性，以及​​初始联合治疗的使用。尽管两个指南都强烈推荐初始单药联合治疗，但 ESC/ESH 指南推荐将其作为≥140/90 mmHg 患者的初始治疗。ACC/AHA 指南推荐将其用于血压高于目标血压 >20/10 mmHg 的患者。因此，唯一真正的分歧是 ACC/AHA 指南坚持认为所有血压 >130/80 mmHg 的人都患有高血压，并且血压应降至 <130/80 mmHg。相比之下，ESC/ESH 指南指出，高血压的定义为 >140/90 毫米汞柱，目标是所有的目标都是 <140/90 毫米汞柱，仅针对心血管高危人群的<130/80 毫米汞柱,