- Design
- Retrospective cross-sectional study in one family health centre
- Population
- 882 adults registered at a family health centre in Izmir, Turkey
- Primary outcome
- Change in office blood pressure category, 2018 vs 2024 ESC
- Effect
- Non-elevated fell from 70.5% to 17.1%; treated at target fell from 53.5% to 30.8%
The 2024 European Society of Cardiology guideline kept the hypertension threshold at 140/90 mmHg but replaced the old optimal, normal and high-normal bands with a single 'elevated' category from 120/70 mmHg, managed according to cardiovascular risk. A cross-sectional study at a family health centre in Izmir applied both systems to the records of 882 adults.
Under the 2018 system, 70.5% had blood pressure below hypertension. Under 2024, only 17.1% were non-elevated: 53.4% of all adults, and three-quarters of those previously below the threshold, moved into the elevated group. Among treated patients, the share at target fell from 53.5% to 30.8%, because the 2024 target is lower.
This does not mean half the practice needs a drug. The elevated category asks for a risk assessment and lifestyle advice, with treatment for those at high risk. But it does change workload, recall lists and how many treated patients look uncontrolled, and practices adopting it should plan for that.
- Recognise that 'elevated' blood pressure prompts a risk assessment, not automatic drug treatment
- Calculate cardiovascular risk for patients newly labelled elevated to decide who needs treatment
- Expect fewer treated patients to meet the lower 2024 target and review uptitration systematically
- Confirm raised clinic readings with home or ambulatory measurement before acting
- Plan recall capacity before switching a practice to the new categories
Why it matters
A relabelling, not new evidence, could double a practice's blood pressure workload overnight.
Don't overread it
This counts reclassifications in one centre's records; it does not show that the new categories improve outcomes.
The statistics, in plain English
These are simple proportions from one practice. They show how labels shift when the definitions change, not how many patients would benefit from treatment.
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