Design: Retrospective cross-sectional study
Population: 882 adults registered at a family health centre in Izmir, Türkiye
Primary outcome: Change in office BP category between 2018 ESC/ESH and 2024 ESC criteria
Effect: 53.4% classed as elevated BP; treated patients at target fell from 53.5% to 30.8%

A cross-sectional study in BMC Primary Care, published on 11 September, reclassified 882 adults at a Turkish family health centre under the 2018 ESC/ESH and 2024 ESC blood pressure categories, using SCORE2 for cardiovascular risk.

The 2024 guideline kept 140/90 mmHg as the threshold for hypertension but created an 'elevated BP' category below it, with management guided by cardiovascular risk. Applied to this list, 53.4% of all adults fell into the elevated group, including 75.7% of those previously considered below the hypertension threshold. Only 17.1% had non-elevated BP. Among treated patients, the share at target fell from 53.5% to 30.8% under the stricter 2024 targets.

This is what the guideline means in a real clinic: more people needing a risk assessment, more follow-up, and more treated patients not at target. It does not mean more people need drugs; for most with elevated BP and low risk, the answer is lifestyle change and recheck.

Indian guidance differs in places, so check which framework your practice follows. Either way, the useful step is to attach a cardiovascular risk estimate to every elevated reading.

Calculate cardiovascular risk for adults with office blood pressure in the elevated range.
Offer lifestyle advice and recheck for most people with elevated BP and low risk.
Confirm elevated readings with home or ambulatory measurement before acting.
Expect more treated patients to fall short of target under the 2024 framework; review them systematically.
Plan recall capacity: the elevated group may be half your adult list.

Why it matters

It turns a guideline category into a workload, and shows how many treated patients now miss target.

The statistics, in plain English

These are proportions from one centre in Izmir, so the exact figures will differ elsewhere. The size of the shift, from 70.5% below threshold to 17.1% non-elevated, is what will generalise.