Hypertension — guideline registry¶
Last updated: 2026-09-01
A catalogue of clinical practice guidelines and formal position statements relevant to hypertension worldwide, including superseded documents with their supersession chains. Every PubMed identifier here was resolved through a live E-utilities query during the build session of 2026-09-01; non-journal documents carry a retrieval URL and access date. This file records documents; the synthesis of what they recommend, and the analysis of where they disagree, lives in wiki/guidelines.md.
Master table¶
| Body | Year | Region | Scope | Citation / identifier | Status |
|---|---|---|---|---|---|
| AHA/ACC + 11 societies | 2025 | USA | Prevention, detection, evaluation, management of high BP in adults | Hypertension 2025;82:e212-e316, PMID 40811516; J Am Coll Cardiol 2025;86:1567-1678, PMID 40815242; Circulation 2025;152:e114-e218, PMID 40811497 | Current |
| ACC/AHA + 10 societies | 2017 | USA | Same scope; introduced ≥130/80 definition | Hypertension 2018;71:e13-e115, PMID 29133356; exec summary PMID 29133354, PMID 29146533; JACC PMID 29146535; synopsis PMID 29357392; systematic review PMID 29133355, PMID 29146534, PMID 30354656 | Superseded by → 2025 AHA/ACC (PMID 40811516) |
| JNC 8 panel members | 2014 | USA | Evidence-based management of high BP in adults | JAMA 2014;311:507-20, PMID 24352797 | Superseded in practice by → 2017 ACC/AHA (PMID 29133356); never formally endorsed by NHLBI |
| JNC 7 (National High Blood Pressure Education Program) | 2003 | USA | Prevention, detection, evaluation, treatment of high BP | JAMA 2003;289:2560-72, PMID 12748199; editorial PMID 12756222 | Superseded by → JNC 8 (PMID 24352797) and → 2017 ACC/AHA (PMID 29133356) |
| ESC | 2024 | Europe | Management of elevated BP and hypertension; introduces "elevated BP" category | Eur Heart J 2024;45:3912-4018, PMID 39210715 | Current (ESC line) |
| ESH | 2023 | Europe | Management of arterial hypertension; endorsed by ISH and ERA | J Hypertens 2023;41:1874-2071, PMID 37345492; clinical-practice condensation Eur J Intern Med 2024;126:1-15, PMID 38914505; ERA nephrology synopsis PMID 38365947 | Current (ESH line) |
| ESC/ESH joint | 2018 | Europe | Management of arterial hypertension | Eur Heart J 2018;39:3021-3104, PMID 30165516; J Hypertens 2018;36:1953-2041, PMID 30234752 | Superseded by → 2023 ESH (PMID 37345492) and → 2024 ESC (PMID 39210715), which diverged into two documents |
| ESH/ESC joint | 2013 | Europe | Management of arterial hypertension | Eur Heart J 2013;34:2159-219, PMID 23771844; J Hypertens 2013;31:1281-357, PMID 23817082; practice guidelines PMID 24107724, PMID 24359485 | Superseded by → 2018 ESC/ESH (PMID 30165516) |
| ISH | 2020 | Global | Global practice guidelines with "essential" and "optimal" care standards | Hypertension 2020;75:1334-1357, PMID 32370572 | Current |
| ISH (with WHL and ESH) | 2024 | Global | Lifestyle management position paper | J Hypertens 2024;42:23-49, PMID 37712135 | Current |
| WHO | 2021 | Global | Pharmacological treatment of hypertension in adults | Exec summary Hypertension 2022;79:293-301, PMID 34775787; German summary PMID 36791691; Americas policy implications PMID 35711684 | Current |
| WHO HEARTS technical package | ongoing | Global | Implementation framework for CVD management in primary care | https://www.who.int/teams/noncommunicable-diseases/hearts-technical-package, accessed 2026-09-01 | Current |
| PAHO HEARTS in the Americas | ongoing | Americas | Regional country-led HEARTS implementation | https://www.paho.org/en/hearts-americas, accessed 2026-09-01 | Current |
| Hypertension Canada | 2025 | Canada | Diagnosis and treatment in adults in primary care; HEARTS-based | CMAJ 2025;197:E549-E564, PMID 40419299 | Current |
| Hypertension Canada | 2020 | Canada | Comprehensive guidelines, adults and children | Can J Cardiol 2020;36:596-624, PMID 32389335 | Superseded by → 2025 Hypertension Canada (PMID 40419299) for adult primary care |
| Chinese Hypertension League and partners | 2024 | China | Diagnosis and management; wearables admitted for screening | Highlights: Hypertens Res 2025;48:1048-1053, PMID 39762483 | Current |
| Japanese Society of Hypertension | 2025 | Japan | Management of hypertension (JSH 2025) | Comparative review Hypertens Res 2026;49:984-987, PMID 41514030; retinal risk-stratification validation PMID 41792247; stroke commentary PMID 42660977 | Current |
| Japanese Society of Hypertension | 2019 | Japan | Management of hypertension (JSH 2019) | Hypertens Res 2019;42:1235-1481, PMID 31375757; key points PMID 31760704; Asian perspective PMID 31891452; paediatric application PMID 34844400 | Superseded by → JSH 2025 (PMID 41514030) |
| Japanese Society of Hypertension | 2014 | Japan | Management of hypertension (JSH 2014) | Key points Pulse (Basel) 2015;3:35-47, PMID 26587456 | Superseded by → JSH 2019 (PMID 31375757) |
| Japanese Society of Hypertension | 2004 | Japan | Management of hypertension (JSH 2004) | Hypertens Res 2006;29 Suppl:S1-105, PMID 17366911; commentary PMID 15948375 | Superseded by → JSH 2014 (PMID 26587456) |
| Japanese Society of Hypertension | 2003 | Japan | Self-monitoring of BP at home | Hypertens Res 2003;26:771-82, PMID 14621179 | Historical; incorporated into later JSH documents |
| JSH / CVIT / JCS | 2026 | Japan | Appropriate use of renal denervation systems, positioned within JSH 2025 | Hypertens Res 2026;49:1815-1824, PMID 42002632 | Current |
| NICE (UK) | 2019 update, reviewed 2026 | UK | Hypertension in adults: diagnosis and management (NG136) | Guideline record PMID 31577399; update summary Br J Gen Pract 2020;70:90-91, PMID 32001477 | Current |
| NICE (UK) | 2011 | UK | Hypertension: clinical management in adults (CG127) | National Clinical Guideline Centre 2011, PMID 22855971; summary PMID 22429432 | Superseded by → NICE NG136 (PMID 31577399) |
| KDIGO | 2021 | Global | BP management in CKD not on dialysis | Kidney Int 2021;99:S1-S87, PMID 33637192; exec summary PMID 33637203; synopsis Ann Intern Med 2021;174:1270-1281, PMID 34152826 | Current |
| Endocrine Society | 2025 | Global | Primary aldosteronism: diagnosis and treatment | J Clin Endocrinol Metab 2025;110:2453-2495, PMID 40658480 | Current |
| ISSHP | 2018 | Global | Hypertensive disorders of pregnancy: classification, diagnosis, management | Hypertension 2018;72:24-43, PMID 29899139; Pregnancy Hypertens 2018;13:291-310, PMID 29803330 | Current |
| ISSHP | 2014 | Global | Revised statement on hypertensive disorders of pregnancy | Pregnancy Hypertens 2014;4:97-104, PMID 26104417 | Superseded by → ISSHP 2018 (PMID 29899139) |
| FIGO | 2019 | Global | Pre-eclampsia: first-trimester screening and prevention | Int J Gynaecol Obstet 2019;145 Suppl 1:1-33, PMID 31111484 | Current |
| AAP | 2017 | USA | Screening and management of high BP in children and adolescents | Pediatrics 2017;140, PMID 28827377 | Current |
| USPSTF | 2021 | USA | Screening for hypertension in adults (Grade A reaffirmation) | JAMA 2021;325:1650-1656, PMID 33904861; commentary PMID 33904916 | Current |
| ESH Working Group on BP Monitoring | 2023 | Europe | Validation of cuffless BP measuring devices | J Hypertens 2023;41:2074-2087, PMID 37303198 | Current |
| ESH | 2025 | Europe | Nocturnal blood pressure: position paper | J Hypertens 2025;43:1296-1318, PMID 40509714 | Current |
| ESH | 2018 | Europe | Isolated systolic hypertension in the young: position paper | J Hypertens 2018;36:1222-1236, PMID 29570514 | Current |
| ESH | 2013 | Europe | Interventional therapy of resistant hypertension: position paper | EuroIntervention 2013;9 Suppl R:R58-66, PMID 23732157 | Historical; predates SYMPLICITY HTN-3 (PMID 24678939) and is superseded in substance by the sham-controlled evidence |
| FMD international consensus | 2019 | Global | Fibromuscular dysplasia: diagnosis and management | Vasc Med 2019;24:164-189, PMID 30648921 | Current |
| Task Force II (international) | 2001 | Global | BP measurement and cardiovascular outcome | Blood Press Monit 2001;6:355-70, PMID 12055415 | Historical |
| AHA/ACC/ADA/ASN | 2026 | USA | Cardiovascular-kidney-metabolic syndrome | Circulation 2026;154:e50-e158, PMID 42263157; J Am Coll Cardiol 2026;87:e1889-e2007, PMID 42265997 | Current — overlaps hypertension management in diabetes and CKD |
| Philippine national panel | 2024 | Philippines | Diagnosis and management of acute severe BP elevation | Exec summary J Clin Hypertens 2026;28:e70199, PMID 41614648 | Current |
| STRIDE BP | ongoing | Global | Registry of validated BP measuring devices | https://www.stridebp.org/, accessed 2026-09-01 | Current — not a guideline, but the operative standard for device selection |
Per-guideline notes¶
2025 AHA/ACC (PMID 40811516). Explicitly retires and replaces the 2017 document. Literature search from December 2023 to June 2024 covering publications since February 2015. Retains the ≥130/80 mm Hg definition and a <130/80 treatment target for most treated adults. Published simultaneously in Hypertension, Circulation and JACC; the three records are the same document.
2017 ACC/AHA (PMID 29133356). The definitional turning point. Its quantified consequence — US crude prevalence 31.9% → 45.6%, drug-recommended proportion 34.3% → 36.2%, proportion above goal among treated adults 39.0% → 53.4% — was published separately (PMID 29133599). Accompanied by a dedicated systematic review and network meta-analysis (PMID 29133355).
2024 ESC (PMID 39210715). Keeps ≥140/90 as hypertension but creates a formal "elevated BP" category at 120–139/70–89 mm Hg, and specifies a systolic target of 120–129 mm Hg where tolerated. This is the closest any guideline comes to transcribing SPRINT directly, and the tolerability caveat is doing substantial work.
2023 ESH (PMID 37345492). Retains ≥140/90 with a staged target approach: to <140/90 first, then toward 130/80 mm Hg if tolerated. Endorsed by ISH and the European Renal Association. The 2024 clinical-practice condensation (PMID 38914505) is the working version; the ERA nephrology synopsis (PMID 38365947) reads it for kidney practice.
The 2018 → 2023/2024 European split. The 2018 ESC/ESH document was joint; the societies subsequently issued separate guidelines with different definitions of the same disease. Any comparison of "the European position" must specify which body.
2021 WHO (PMID 34775787). Developed under the WHO Handbook for Guideline Development with GRADE. Treatment-focused rather than diagnosis-focused, and unusual in explicitly addressing task-shifting, single-pill combinations, follow-up intervals and health-worker roles — i.e. the delivery problem rather than the science.
2020 ISH (PMID 32370572). Two-tier "essential" and "optimal" standards, designed so that a recommendation exists for settings without ambulatory monitoring, laboratory access or specialist referral.
2025 Hypertension Canada (PMID 40419299). Nine recommendations, primary-care authored, built on the WHO HEARTS framework, using GRADE and ADAPTE with AGREE II reporting. Adopts ≥130/80 mm Hg and a systolic target <130 mm Hg. Notable for explaining its own motivation: Canadian treatment and control rates had regressed.
2024 Chinese (PMID 39762483). Retains ≥140/90 for diagnosis but recommends <130/80 for most if tolerated, admits validated smart wearables for screening and monitoring, and adds sleep and mental health to lifestyle recommendations alongside low-sodium potassium-rich salt substitutes and a Chinese heart-healthy diet.
2021 KDIGO (PMID 33637192). Systolic <120 mm Hg by standardised office measurement for most adults with CKD not on dialysis, excluding children and kidney transplant recipients. Introduces a chapter dedicated to measurement because the pivotal trials used standardised protocols — the most methodologically explicit response in any guideline to the measurement problem.
2025 Endocrine Society, primary aldosteronism (PMID 40658480). Suggests screening all people with hypertension by aldosterone, renin and the aldosterone-renin ratio; a probability-stratified pathway to confirmatory testing and lateralisation; mineralocorticoid receptor antagonists preferred over ENaC inhibitors, spironolactone preferred on cost and availability; and titration of mineralocorticoid receptor antagonist dose to raise renin in those with suppressed renin and uncontrolled hypertension.
2021 USPSTF (PMID 33904861). Grade A reaffirmation: screen all adults ≥18 with office measurement, and obtain out-of-office measurements for diagnostic confirmation before starting treatment. High certainty of substantial net benefit.
Disagreements and gaps¶
| Question | Positions | Status |
|---|---|---|
| Diagnostic threshold | ≥130/80: 2025 AHA/ACC, 2025 Hypertension Canada. ≥140/90: 2023 ESH, 2024 ESC, 2024 Chinese, 2020 ISH, 2021 WHO, NICE | Unresolved; mostly a labelling rather than a prescribing difference (PMID 29133599) |
| Treatment target | <130/80 (AHA/ACC, Canada, Chinese); 120–129 systolic where tolerated (ESC); staged <140/90 then toward 130/80 (ESH); <120 in CKD (KDIGO) | Converging downward, but from different reasoning |
| Measurement method for the target | Mandate standardised office readings (KDIGO); mandate out-of-office confirmation for diagnosis (NICE, USPSTF); largely implicit (most others) | The central unresolved methodological gap |
| Wearable/cuffless devices | Admitted for screening and monitoring (2024 Chinese); not admitted, validation protocol issued instead (ESH) | Direct conflict |
| Age-based thresholds | Retained in several documents; BPLTTC recommends removal (PMID 34461040) | Evidence ahead of guidance |
| Primary aldosteronism screening | Universal screening suggested (Endocrine Society 2025); targeted screening in general hypertension guidelines | Direct conflict, unresolved |
| Diabetes targets | Several documents still reflect ACCORD-BP-era caution; ESPRIT (PMID 38945140) and BPROAD (PMID 39555827) supersede it | Evidence ahead of guidance |
| Inpatient BP targets | No guideline sets one | Complete gap; observational evidence suggests current practice is harmful (PMID 37252732) |
| Frail and very old people | Cochrane names this the priority evidence gap (PMID 39688187) | Gap in both evidence and guidance |
| Resource-stratified thresholds | ISH two-tier standards; economic modelling suggests ≥160 mm Hg maximises net benefit in the lowest-income settings (PMID 38626959) | Acknowledged only obliquely by clinical guidelines |
Watch list¶
- JSH 2025 — full English-language primary publication to be catalogued when indexed; currently represented here through the comparative review (PMID 41514030), the retinal risk-stratification validation (PMID 41792247) and the renal denervation positioning statement (PMID 42002632).
- 2024 Chinese guidelines — primary document not yet indexed in PubMed in English; currently represented by the highlights paper (PMID 39762483).
- Next NICE review — NG136 record shows a 2026 review date (PMID 31577399).
- Endocrine Society universal PA screening — whether any general hypertension guideline adopts it, and whether a health system models the false-positive burden.
- Baxdrostat and zilebesiran outcome trials (NCT06742723, NCT07181109) — either could force a guideline revision cycle out of schedule.
- Renal denervation positioning — the Japanese multi-society appropriate-use document (PMID 42002632) is the first national attempt to place denervation formally; whether ESC/ESH and AHA/ACC follow is the question.
- Cuffless device validation — whether any device meets the ESH protocol (PMID 37303198) well enough for other guidelines to follow the Chinese position.