How to implement the recommendations of the 2018 ESC/ESH Hypertension Guidelines in a given patient: a step by step approach

All clinical guidelines release general recommendations based on the best available evidence on the issue, usually obtained from epidemiological studies, randomized clinical trials, or meta-analyses. However, the final data of these studies are averages of a given parameter from groups of patients whose clinical characteristics are not necessarily similar to those of a specific patient seen in daily practice. As the guidelines recommendations have to be implemented in patients, not in group of patients, the final decisions concerning an individual patient must be made by the attending physician, in consultation with the patient and caregiver, as appropriate. In this article, a clinical case of a patient with hypertension and other associated cardiovascular risk factors is discussed and managed following the recommendations of the 2018 ESC/ESH Hypertension Guidelines implemented in this specific patient.