The 2018 ESC/ESH Guidelines for the management of arterial hypertension provide updated recommendations based on the latest scientific evidence. The guidelines aim to improve the detection and treatment of hypertension, and to enhance blood pressure (BP) control rates. Key changes include: 1. **Wider Use of Out-of-Office BP Measurement**: Ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM) are recommended as options to confirm hypertension diagnosis, detect white-coat and masked hypertension, and monitor BP control. 2. **Less Conservative Treatment in Older Patients**: Lower BP thresholds and treatment targets are suggested for older patients, emphasizing biological rather than chronological age. 3. **Single-Pill Combination (SPC) Therapy**: SPC therapy is preferred for initial treatment, with ACE inhibitors or ARBs combined with CCBs and/or thiazides as the core strategy. 4. **New Target Ranges for Treated Patients**: Target BP ranges are updated to better identify recommended targets and safety boundaries based on patient age and comorbidities. 5. **Evaluation of Treatment Adherence**: Poor adherence to drug therapy is emphasized as a major cause of poor BP control. 6. **Role of Nurses and Pharmacists**: Their important role in education, support, and follow-up of treated hypertensive patients is highlighted. The guidelines also cover definitions, classification, and epidemiological aspects of hypertension, emphasizing the continuous relationship between BP and cardiovascular (CV) and renal events. They recommend the use of the Systematic COronary Risk Evaluation (SCORE) system for CV risk assessment, considering factors such as age, sex, smoking, cholesterol, and SBP. The guidelines stress the importance of hypertension-mediated organ damage (HMOD) in refining CV risk assessment and address challenges in CV risk assessment, including the impact of concomitant diseases and the use of treated BP values in risk calculators. Additionally, the guidelines provide detailed recommendations for BP measurement, including conventional office BP, unattended office BP, out-of-office BP, HBPM, and ABPM, with specific procedures and considerations for each method.The 2018 ESC/ESH Guidelines for the management of arterial hypertension provide updated recommendations based on the latest scientific evidence. The guidelines aim to improve the detection and treatment of hypertension, and to enhance blood pressure (BP) control rates. Key changes include: 1. **Wider Use of Out-of-Office BP Measurement**: Ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM) are recommended as options to confirm hypertension diagnosis, detect white-coat and masked hypertension, and monitor BP control. 2. **Less Conservative Treatment in Older Patients**: Lower BP thresholds and treatment targets are suggested for older patients, emphasizing biological rather than chronological age. 3. **Single-Pill Combination (SPC) Therapy**: SPC therapy is preferred for initial treatment, with ACE inhibitors or ARBs combined with CCBs and/or thiazides as the core strategy. 4. **New Target Ranges for Treated Patients**: Target BP ranges are updated to better identify recommended targets and safety boundaries based on patient age and comorbidities. 5. **Evaluation of Treatment Adherence**: Poor adherence to drug therapy is emphasized as a major cause of poor BP control. 6. **Role of Nurses and Pharmacists**: Their important role in education, support, and follow-up of treated hypertensive patients is highlighted. The guidelines also cover definitions, classification, and epidemiological aspects of hypertension, emphasizing the continuous relationship between BP and cardiovascular (CV) and renal events. They recommend the use of the Systematic COronary Risk Evaluation (SCORE) system for CV risk assessment, considering factors such as age, sex, smoking, cholesterol, and SBP. The guidelines stress the importance of hypertension-mediated organ damage (HMOD) in refining CV risk assessment and address challenges in CV risk assessment, including the impact of concomitant diseases and the use of treated BP values in risk calculators. Additionally, the guidelines provide detailed recommendations for BP measurement, including conventional office BP, unattended office BP, out-of-office BP, HBPM, and ABPM, with specific procedures and considerations for each method.