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In 2018, at the annual congresses of the European Society of Hypertension and European Society of Cardiology, the updated guidelines on the diagnostics, management and prevention of arterial hypertension were announced, followed by their publication in the European Heart Journal. The guidelines present a comprehensive overview on the definition and classification of arterial hypertension, approaches to the blood pressure measurement, assessment of the target organ damage, special patient subgroups and other issues. Despite a detailed analysis of various issues of the diagnostics and treatment of hypertension, some of the statements appear to be disputable and raise discussion among specialists in hypertension field. The diagnostic criteria, threshold and target blood pressure levels are the most debatable issues involving comparisons with the guidelines of the American Heart Association (2017). This paper gathers a number of comments on the less discussed questions of the diagnostics, treatment and prevention of hypertension. This collection of letters of the specialists, members of the Russian Society of Cardiology includes both personal expert opinions and well-known facts, reflects the controversy of the available evidence and indicates the blanks and gaps in hypertensiology giving perspective for potential future studies.

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