ReviewApplication of hypertension guidelines in clinical practice: implementation of the 2007 ESH/ESC European practice Guidelines in Spainde la Sierra, Alejandroa; Zamorano, Jose Luisa,b; Ruilope, Luis MbAuthor Information aHypertension Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain bHypertension Unit, Hospital 12 de Octubre, Madrid, Spain Correspondence to Alejandro de la Sierra, Hypertension Unit, Department of Internal Medicine Hospital Clinic Villarroel 170, 08036-Barcelona, Spain Tel: +34932279364; fax: +34932279365; e-mail: [email protected] Sponsorship: Medical writing assistance for the preparation of this manuscript was provided by Trevor Speight. This assistance was funded by Novartis. Conflicts of interest: Dr. de la Sierra declares honoraria for acting as an ‘expert consultant’ or for speaker engagements in sponsored meetings from major pharmaceutical companies. Journal of Hypertension: June 2009 - Volume 27 - Issue - p S27-S32 doi: 10.1097/01.hjh.0000356769.32130.95 Buy Metrics Abstract Clinical practice guidelines on the management of hypertension such as the 2007 European Society of Hypertension (ESH)/European Society of Cardiology (ESC) Guidelines were developed with the objective of allowing a greater number of patients with high blood pressure to be detected and effectively treated. The acceptance of hypertension guidelines and their implementation in clinical practice by ‘front-line’ physicians continues to be less than optimal for a variety of reasons, however, including the gap between academic guideline writers and those whose task it is to implement the guidelines, the physicians’ own attitudes and knowledge, the characteristics of the guideline itself, patient-related factors, and external barriers such as a lack of adequate resources. In Spain, a survey of the opinions of Spanish physicians on the 2007 ESH/ESC hypertension Guidelines found that there was agreement that the guidelines allow a better stratification of cardiovascular risk, better control of risk factors related to hypertension, better implementation of an individualized treatment programme, and facilitate choice of the best therapeutic approach for each patient, but there was no consensus that adherence to the guidelines achieves better control of hypertension or that it is more likely to prevent future cardiovascular events. In future, there needs to be a continuous process involving education and audit that takes into account the full spectrum of barriers to acceptance and implementation of hypertension guidelines to ensure that their full potential in reducing the strain on healthcare delivery systems imposed by undiagnosed, untreated and uncontrolled hypertension can be realized. © 2009 Lippincott Williams & Wilkins, Inc.