Risk-based treatment strategy in ELEVATEd blood pressure (ELEVATE)
Aim
The project is based on the hypothesis that early blood pressure treatment for patients with high blood pressure and a high cardiovascular risk can lower the risk of heart and blood vessel problems and slow down organ damage, while keeping a reasonable safety profile and quality of life.
Description
Elevated blood pressure (BP) – typically between 120 The project is based on the idea that early blood pressure treatment for patients with high blood pressure and a high cardiovascular risk can lower the risk of heart and blood vessel problems and slow down organ damage, while keeping a reasonable safety profile and quality of life. –139 mmHg systolic and/ or 70–89 mmHg diastolic – is very common, affecting nearly half of all adults in Europe. While this is not yet classified as hypertension, it still increases the risk of serious cardiovascular events like heart attacks and strokes. In fact, about one in three heart attacks and strokes happen in people with BP below 140/ 90 mmHg, the usual threshold for starting treatment.
Yet in Europe, there is no clear, unified approach: some medical guidelines suggest only monitoring, while others recommend starting BP-lowering medication for people with other cardiovascular risk factors. This lack of agreement leads to uncertainty for both doctors and patients.
ELEVATE is an international, pragmatic, open-label, randomized, parallel-group, investigator-initiated interventional clinical trial involving partners from France, Ireland, Poland, Italy, and Latvia.
The project will compare two treatment strategies:
- The European Society of Hypertension (ESH) approach – standard care consisting of lifestyle recommendations, with antihypertensive treatment initiated only after a diagnosis of hypertension.
- The European Society of Cardiology (ESC) approach – a risk-based strategy in which patients with elevated blood pressure and high cardiovascular risk receive antihypertensive monotherapy.
The project also includes the long-term evaluation of effectiveness and safety outcomes using electronic health data, hospitalisation and mortality registries, as well as general practitioners' medical records.
Active involvement of patients, general practitioners, pharmacists, nurses, professional societies, and other stakeholders is a key component of the project, ensuring that the findings can be effectively translated into routine clinical practice.
ELEVATE will help launch a new European Hypertension Research Network, creating lasting collaboration for future studies in cardiovascular prevention. The ultimate goal is to reduce the burden of heart disease – the leading cause of death in Europe – and help more people live longer, healthier lives.
Why Latvia?
Latvia represents the high cardiovascular risk country group in the ELEVATE consortium. Heart and blood vessel diseases are still the leading cause of death in Latvia, and the prevalence of hypertension is among the highest in Europe. In such circumstances, testing the effectiveness of risk-based treatment strategies is particularly relevant − and the data obtained in Latvia will provide a significant contribution to the overall European evidence base. At the same time, ELEVATE will give the opportunity to evaluate how this approach works within Latvia's healthcare system, including in family doctor practices and using national registries for long-term monitoring.
Project coordinator
- Consortium Coordinating Investigator: Hôpital Européen Georges Pompidou, Paris, France
- Sponsor/Sponsor representative: Assistance Publique – Hôpitaux de Paris, France
Project partners
- Internal diseases department Riga Stradins university, Latvia
- Department of Cardiology, School of Medicine, College of Medicine, Nursing and Health Sciences, University of Galway, Ireland
- Department of Hypertension and Diabetology, Medical University of Gdansk, Poland
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, Milan, Italy
Project related news
- The project started on 01.06.2026. Recruitment is planned from 2027.
- The ELEVATE project kick-off meeting will take place in Paris on September 8–9, 2026 - the first joint meeting where researchers from five European countries - France, Ireland, Poland, Italy, and Latvia - will start actively implementing the project. The team from Riga Stradiņš University will participate as a full-fledged consortium partner.
