The guideline committee used the ADAPTE97 framework to select international hypertension guidelines published over the previous 10 years. The committee considered the quality and availability of evidence reviews, use of GRADE or similar grading frameworks to rate the strength of recommendations and certainty of evidence systematically and explicitly, clarity of recommendations, and publication time frames when selecting the source guidelines: American Heart Association,99 WHO,71 and the European Society of Cardiology (ESC).63 The committee used the existing evidence syntheses and GRADE levels from each of these source guidelines when developing the recommendations. The ESC guideline had the most recently updated recommendations (published in August 2024), with evidence tables updated to January 2024, with the exception of the Effects of Intensive Blood Pressure Lowering Treatment in Reducing Risk of Cardiovascular Events (ESPRIT) trial, which was published in June 2024.28,63
