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with decreased mortality or CVD outcomes.984 On the other hand, vigilance is needed because withholding ACE inhibitors has also been shown to increase post-operative hypertension.985 In patients with heart failure, loop diuretics can be continued in patients prone to volume overload.986 CCBs are generally considered safe pre-operatively.

11 Patient-centred care

in hypertension

11.1 Definition

Patient-centred care is defined as an attitude of the healthcare professional that closely aligns with the patient’s preferences and needs.987 In the patient-centred approach (Figure 23), patients are viewed as active participants in health services, who work as partners alongside healthcare professionals. A patient-centred approach is associated with higher satisfaction rates, better adherence to recommendations and prescriptions, and better treatment, particularly in the management of chronic illness, such as hypertension.988 While there is limited evidence for the efficacy and effectiveness of specific shared decision- making intervention strategies in hypertension care,989 it is viewed as an ethical imperative in healthcare practice and health policy, and in clinical guidelines.130

11.2 Communicating consequences of

treatment In line with patient-centred care, it is important to assess whether patients understand their hypertension-related risk, the rationale for any hypertension treatment, the benefits and harms of hypertension treatment, and that the treatment plan is also centrally guided by what matters most to the patient. Risk communication is challenging, and providers need to be led by the individual’s preferences when presenting more detailed numeric and visual representations of risk and the likely benefits and harms of hypertension treatment. Socio-demographic differences in healthcare need to be considered in patient–provider communication.990,991 Standard approaches to communicate consequences of treatment can involve 10-year risk of a CVD event with SCORE2 or SCORE2-OP. Alternatively, individual risk and risk reduction can be communicated in terms of ‘risk age’ or ‘heart age’ (Section 7.3).

P a t i e n t

Lifestyle (inclusive of health behaviour and social context)

Medications Multidisciplinary medical team

Self-care Family

Figure 23 Patient-centred care. Downloaded from academic.oup.com/eurheartj/article/45/38/3912/7741010 by guest on 07 October 2026