Clinical guidelines

Answers begin with the guideline that applies, from the societies your field works with, applied to the patient in front of you.

The guideline card

When a question is one a guideline answers, the answer opens with a card: the society's name, the recommendation in the guideline's words, the reference. What follows applies the recommendation to this patient, with her values and her history.

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An answer opening with a guideline card: 'Practice guideline, European Society of Cardiology' in the header, the recommendation in two sentences with a bold phrase, the reference beneath it; below the card the first paragraph applying it to the patient with chart chips.

Which guidelines

  • S3 guidelines of the AWMF register and the guidelines of DEGAM for general practice.
  • National care guidelines (NVL) for everyday care.
  • ESC and EAS guidelines for prevention, lipids and blood pressure.
  • The practice recommendations of the Deutsche Diabetes Gesellschaft.
  • Product information from the EMA for dosing and label.
  • Decisions of the G-BA where they change what can be prescribed.

Each guideline is cited with its year and version. Where a newer version exists, the answer uses it and says so.

What does the current guideline recommend as her blood pressure target?

Answered on the chart of Anna Keller, 47

Practice guidelineEuropean Society of Cardiology

The 2024 ESC guideline recommends a systolic target of 120 to 129 mmHg for most adults on treatment, provided it is tolerated, and home blood pressure monitoring to guide treatment; home readings run about 5 mmHg below office values. Eur Heart J

For her: home mean 136/86 mmHg and office 142/90 are above target on ramipril 5 mg. BP log 15.09.2026 Visit 16.09.2026 The guideline's first step is to optimise the existing drug or move to a combination; with eGFR 92 and normal potassium, ramipril 10 mg is the straightforward step, with a combination (ramipril plus amlodipine) if the home mean stays above 135/85 after four weeks. Lab 08.05.2026 Eur Heart J

Home measurement: seated after five minutes of rest, two readings in the morning and two in the evening for seven days, discarding the first day. Her log follows that scheme. BP log 15.09.2026 Eur Heart J

See the full response

Applied to this patient

A guideline recommends for a population. The answer says what that means for the patient: which of the options apply to her, which are ruled out by a value in her chart, and which question is still open. That is the difference between reading a guideline and answering with one.

Local protocols next to the guideline

Where your practice has its own standard, it appears next to the guideline with its own chip. See Your own documents and protocols.