Hypertension: In the US it is already hypertension, in Germany still normal


Hypertension is a common problem in developed countries. The risk of heart attacks and strokes increases with the pressure in the vessels. The US has therefore recently changed the definition of high blood pressure and corrected the values ​​downwards. With a stroke, millions of Americans suddenly had hypertension. The central question was: is Germany catching up? Now the decision has been made.

In Germany, the definition of hypertension remains as it was previously: Hypertension is present at a value of 140/90 mm Hg or more. In the US, high blood pressure is used when the value is 130/80 mm Hg or higher.

What does mm Hg mean? mm Hg is the abbreviation for millimeters of mercury. It is the measure of static pressure used primarily for blood pressure. Pressure was previously measured in medicine and other sciences with a column of mercury.

Why did the US lower the value?

The main trigger for the change in medical guidelines in the US was the so-called SPRIN T study from the United Kingdom, which was published in 2015. Because the three-year investigation with several thousand high blood pressure patients was discontinued. The reason: The participants, whose blood pressure was lowered by drugs to 120 to 80, were so clearly in the advantage that the other patients, whose blood pressure was not lowered so much, no longer wanted to take the increased risks. In the group with the target blood pressure of less than 120 mm Hg (upper value), there were almost a quarter fewer deaths and almost a third fewer negative cardiovascular events such as heart attacks than in the target blood pressure group less 140 mm Hg.

However, it should not be forgotten that the participants who had taken antihypertensive drugs, although benefiting from the lower risks, but sometimes suffered from considerable side effects. The rate of serious adverse events was increased, including hypotension, blood pressure levels below 100 to 60 mm Hg, circulatory collapse, electrolyte disturbances or acute renal failure.

Why does Germany not go home?

The medical societies in Europe and Germany do not follow the US and leave the high blood pressure where they were. This was decided by the high-pressure specialists at the Congress of the European Society of Hypertension (ESH), which met in Barcelona in June. There, the European guidelines were presented, in which also the German ones are oriented. The new guidelines continue to adhere to the existing disease definition of ≥140 / 90 mm Hg. However, it is recommended to “strive” to keep the blood pressure in the normal range of patients The German Hypertension League explained the decision at the European level as follows: “The European guidelines committee did not see sufficient evidence for such a recommendation.” The new guideline continues to treat the majority of hypertensive patients only with a blood pressure of 140/90 mm Hg. ” explained Dr. Peter Trenkwalder, Deputy Chairman of the German High Pressure League.

Like the previous guideline, the new differentiate between an optimal blood pressure range ( “In general, however, high blood pressure is a complex clinical picture and modern hypertension therapy should be individualized, the guidelines merely set the rough framework,” Bernhard Krämer, President of the German High Pressure League e. V ..

More information about hypertension with tables can be found here.

How common is hypertension in Germany?

Hypertension (arterial hypertension) is the leading cause of mortality in Germany. Every third German aged between 18 and 79 suffers from hypertension. In the group of 70 to 79 year olds, there are even three quarters. In many, the hypertension remains untreated.

In order to reduce the risks to the heart and circulation, the blood pressure should be corrected. In many cases, this is already possible without medication, such as weight loss and more exercise. In other cases, hypotensive agents are needed.


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