ESC 2024 Guidelines — Elevated Blood Pressure and Hypertension

The 2024 guideline introduces a category between normal and hypertensive — "elevated blood pressure" — and ties treatment of that group to cardiovascular risk rather than to the reading alone. It also commits to a systolic target of 120 to 129 mmHg for most treated patients where it is tolerated, which is a substantive change from the previous text and a reliable source of questions.

The rest of the examinable ground: confirming the diagnosis outside the office, when to look for a secondary cause and what to do first when a patient is resistant on three drugs — objective adherence testing before the work-up, not after. The acute settings have their own recommendations with specific numbers, particularly the permitted magnitude of blood pressure reduction in intracerebral haemorrhage. And pregnancy, where renin-angiotensin system blockers are contraindicated and the substitution has to be immediate.

Many of these recommendations are quantitative. The questions here are written so that the number decides the answer.