A patient-friendly summary of the key messages from ESC Congress 2026 in Munich

At the annual congress of the European Society of Cardiology (ESC), held in Munich from 28 to 31 August 2026, three new clinical practice guidelines and the Fifth Universal Definition of Myocardial Infarction were presented. These recommendations will directly influence the everyday assessment and treatment of a large number of patients – from people who have no symptoms but are at increased risk, to patients following a myocardial infarction, those with heart failure, and those living with both cardiovascular and kidney disease.

The common thread running through all these documents is clear: do not wait for advanced disease. Identify risk earlier, begin treatment in a timely manner and involve the patient in shared decision-making.

1. Heart Failure: A Simpler Classification and Earlier Treatment

The new ESC Guidelines for the management of heart failure introduce a stage-based approach – from people with risk factors, through preclinical cardiac changes, to symptomatic and advanced heart failure. Prevention therefore receives the same emphasis as the treatment of established disease. High blood pressure, diabetes, obesity, coronary artery disease, kidney disease and cardiac arrhythmias are no longer viewed merely as accompanying conditions, but as opportunities for intervention before breathlessness, swelling and fatigue appear.

Two Groups According to Ejection Fraction

The previous division into heart failure with reduced, mildly reduced and preserved ejection fraction has been simplified. The Guidelines now distinguish heart failure with a left ventricular ejection fraction below 50% from heart failure with an ejection fraction of 50% or higher. The reason is practical: patients in the former ‘intermediate’ group often have similar disease mechanisms and derive similar treatment benefits to patients with reduced cardiac function.

It is important to emphasise that a normal ejection fraction does not exclude heart failure. The diagnosis is made by linking symptoms and signs with the findings of echocardiography, natriuretic peptide testing, electrocardiography and other investigations. Parameters such as diastolic function, left atrial size and myocardial strain can help identify abnormalities at an earlier stage.

New Treatment Terminology

The sometimes imprecise term ‘guideline-directed medical therapy’ has been replaced by three clearer categories: foundational medical therapy, supported by the strongest evidence; additional medical therapy for specific patient groups or symptoms; and guideline-directed interventional therapy, including devices and procedures. This framework is intended to facilitate individualised treatment and allow recommendations to evolve rapidly as new evidence emerges.

Highlighted changes include stronger recommendations for mineralocorticoid receptor antagonists in chronic heart failure irrespective of ejection fraction, as well as the option of semaglutide or tirzepatide in selected patients with preserved ejection fraction and obesity. Recommendations have also been upgraded for certain additional medicines, durable mechanical circulatory support and transcatheter treatment of mitral regurgitation. Treatment selection must nevertheless always take account of the clinical presentation, blood pressure, kidney function, potassium level and coexisting conditions.

2. Cardiac Rehabilitation Becomes an Integral Part of Treatment

For the first time, the ESC has published dedicated, comprehensive Guidelines on cardiac rehabilitation. This sends an important message: recovery following a myocardial infarction, cardiac surgery or worsening heart disease does not end at hospital discharge or with the prescription of medication.

A high-quality rehabilitation programme is delivered by a multidisciplinary team and includes individually prescribed exercise, management of risk factors, correct use of medication, nutritional guidance, smoking cessation, psychological support and a plan for returning to everyday activities. The goal is not only improved physical fitness, but also fewer recurrent cardiovascular events, greater confidence, restored independence and a better quality of life.

Cardiac rehabilitation is recommended after myocardial infarction and in heart failure, while patients with atrial fibrillation, congenital heart disease, those who have undergone heart valve replacement, and people treated with potentially cardiotoxic cancer therapies may also benefit. For selected patients, digitally supported home-based programmes with remote monitoring and teleconsultations may be appropriate.

3. The Heart and Kidneys Must Be Assessed Together

The first ESC Guidelines specifically dedicated to the management of cardiovascular disease in patients with chronic kidney disease were developed in collaboration with the European Renal Association. They emphasise that heart disease can accelerate kidney damage, while chronic kidney disease substantially increases the risk of heart failure, myocardial infarction, arrhythmias, stroke and sudden cardiac death.

The practical framework known as STAMP on CKD covers screening, triage and risk assessment, early action to address risk, modification of cardiovascular management, and planning of healthcare services. The most important change for everyday practice is the recommendation that patients with cardiovascular disease should be assessed for kidney disease using both blood and urine tests: estimated glomerular filtration rate (eGFR) and the urine albumin-to-creatinine ratio (UACR). Serum creatinine alone is not always sufficient.

The Guidelines support the early use of proven therapies that protect both the heart and kidneys, including renin-angiotensin system inhibitors, SGLT2 inhibitors and statin-based therapy, when indicated and safe for the individual patient. They also emphasise dose adjustment according to kidney function, electrolyte monitoring, and close collaboration between cardiologists, nephrologists and primary care physicians.

4. A New Definition of Myocardial Infarction: The Cause Matters, Not Only the Number

The Fifth Universal Definition of Myocardial Infarction, a joint document from the ESC, ACC, AHA and World Heart Federation, replaces the previous numerical classification with three clinically more meaningful categories: primary, secondary and procedure-related myocardial infarction.

Primary myocardial infarction results from an acute problem in a coronary artery – most often rupture of an atherosclerotic plaque, but also spontaneous coronary artery dissection, coronary spasm or thrombosis. Secondary myocardial infarction occurs when myocardial oxygen demand exceeds oxygen supply because of another serious condition, such as a very rapid heart rate, markedly high or low blood pressure, anaemia or severe hypoxaemia. A procedure-related myocardial infarction occurs in temporal association with a cardiac procedure or operation.

An elevated troponin level indicates myocardial injury, but does not automatically establish a diagnosis of myocardial infarction. Diagnosis requires an appropriate rise or fall in troponin together with clinical evidence of myocardial ischaemia, such as typical symptoms, ECG changes or relevant imaging findings. The new definition incorporates sex-specific troponin thresholds and encourages the use of imaging to clarify the cause of myocardial injury.

What Do All the New Guidelines Have in Common?

Although they address different topics, the new documents share several important messages:

prevention and early detection must begin before severe symptoms develop;

treatment should be tailored to the patient’s phenotype, comorbidities and the true mechanism of disease;

the heart, kidneys, metabolism, physical capacity and mental health should be viewed as interconnected;

rehabilitation, education and self-care deserve the same attention as medication and procedures;

decisions should be made together with the patient, with regular monitoring of treatment effectiveness and safety.

When Should You Not Wait for a Routine Appointment?

Urgent medical assessment is required for new or severe chest pain or pressure, sudden shortness of breath, cold sweating, nausea, loss of consciousness, new weakness on one side of the body, or a sudden deterioration in general condition. Patients with known heart failure should also seek earlier assessment if they experience rapid weight gain, increasing swelling, breathlessness at rest, or the need to sleep propped up on additional pillows.

A Message from Dr Mačkić Practice

The new ESC Guidelines do more than change names and tables – they change the point at which we act. Their greatest benefit is achieved when an individual’s risk is recognised early, the diagnosis is confirmed with appropriate tests and treatment is monitored over time. A cardiology consultation, ECG, contemporary echocardiography, assessment of kidney function and albuminuria, and targeted laboratory monitoring allow the recommendations to be applied to the individual patient rather than to the diagnosis alone.

This article is provided for general information and cannot replace a medical consultation or an individual treatment plan. Medication should not be started, changed or discontinued without consulting a physician.

Official Sources

ESC: 2026 ESC Guidelines for the management of heart failure – https://www.escardio.org/guidelines/clinical-practice-guidelines/all-esc-practice-guidelines/heart-failure/

ESC: 2026 ESC Guidelines on Cardiac Rehabilitation – https://www.escardio.org/guidelines/clinical-practice-guidelines/all-esc-practice-guidelines/cardiac-rehabilitation/

ESC: 2026 ESC Guidelines for cardiovascular disease and chronic kidney disease – https://www.escardio.org/guidelines/clinical-practice-guidelines/all-esc-practice-guidelines/cvd-chronic-kidney-disease/

ESC: Fifth Universal Definition of Myocardial Infarction (2026) – https://www.escardio.org/guidelines/clinical-practice-guidelines/all-esc-practice-guidelines/fifth-universal-definition-myocardial-infarction/

Naravno — evo prevedene verzije članka na engleskom:

Obesity is a chronic, complex and often progressive condition characterized by excessive accumulation of body fat, particularly visceral fat. Today, obesity is increasingly recognized as a chronic disease, rather than merely a matter of appearance, self-discipline or lifestyle.

The most commonly used measure is the body mass index — BMI, calculated as body weight in kilograms divided by height in meters squared. Overweight is defined as a BMI of 25–29.9 kg/m², while obesity is defined as a BMI ≥30 kg/m². However, BMI is not a perfect marker, as it does not distinguish between fat and muscle mass and does not show fat distribution. Therefore, waist circumference, waist-to-height ratio, blood pressure, glucose levels, lipid profile, liver enzymes and overall cardiometabolic risk are also important.

Why Is Obesity Dangerous?

Obesity significantly increases the risk of many diseases. It is associated with arterial hypertension, type 2 diabetes, dyslipidaemia, fatty liver disease, obstructive sleep apnoea, osteoarthritis, gallbladder disease, infertility and certain types of cancer.

From a cardiology perspective, obesity is one of the most important risk factors. It increases the risk of high blood pressure, coronary artery disease, heart failure, atrial fibrillation and worsening of already existing cardiovascular disease. Obesity is therefore not only a cosmetic issue, but a serious medical condition with major long-term health consequences.

It is important to know that even moderate weight loss can bring significant health benefits. A reduction in body weight of 5–10% may improve blood pressure, blood glucose control, lipid profile, joint symptoms, sleep quality and overall energy levels. The goal of treatment is not only a lower number on the scale, but a reduction in health risk and an improvement in quality of life.

How Should Obesity Be Treated?

The treatment of obesity should be individual, medically supervised and long-term. Short-term diets often provide temporary results, but without sustained lifestyle changes, follow-up and professional support, weight regain is common.

Modern treatment includes several therapeutic levels.

1. Lifestyle Modification

The foundation of obesity treatment is healthy nutrition, increased physical activity, good sleep and behavioural change. There is no single ideal diet for every patient. The most important factor is that the nutrition plan is sustainable, medically appropriate and adapted to the individual.

In everyday practice, the following measures are usually recommended:

• moderate calorie deficit,
• increased intake of vegetables, legumes, whole grains and protein,
• reduced intake of sugar, sweetened beverages, alcohol and ultra-processed foods,
• regular physical activity,
• strength exercises to preserve muscle mass,
• adequate sleep,
• stress management.

In patients with cardiovascular disease, physical activity should be adapted to heart function, blood pressure, symptoms and current therapy.

2. Medical Assessment Before Treatment

Before starting obesity treatment, it is important to assess whether obesity-related complications are already present. This usually includes blood pressure measurement, ECG, laboratory tests, glucose/HbA1c, lipid profile, liver enzymes, kidney function, thyroid function, assessment of sleep apnoea risk and cardiology evaluation in patients with symptoms or known heart disease.

In some patients, obesity may be associated with medications, endocrine disorders, reduced physical activity due to other diseases, sleep disorders or psychological factors. For this reason, the patient should not be assessed only by body weight, but within the full medical context.

3. Pharmacological Treatment of Obesity

Today, several medications can help in the treatment of obesity. However, they are not a replacement for lifestyle modification. They are used as an addition to nutrition, physical activity and regular medical follow-up.

Pharmacological therapy is usually considered in patients with BMI ≥30 kg/m², or in patients with BMI ≥27 kg/m² who also have obesity-related complications such as hypertension, diabetes, dyslipidaemia, sleep apnoea or cardiovascular disease.

Available therapeutic options include:

Orlistat — a medication that reduces the absorption of fat in the intestine. It may be useful in selected patients, but gastrointestinal side effects are common.

Naltrexone/bupropion — a combination that acts on appetite and reward pathways in the brain. It is used together with diet and physical activity in adults with obesity or overweight with associated complications. It is not suitable for all patients and requires careful medical assessment, particularly in patients with high blood pressure, neurological or psychiatric conditions.

Liraglutide  — a GLP-1 receptor agonist administered once daily. It helps reduce appetite, increases satiety and supports weight loss.

Semaglutide — a GLP-1 receptor agonist administered once weekly. It is one of the most effective pharmacological options for obesity treatment. In addition to weight reduction, semaglutide has also shown cardiovascular benefit in patients with overweight or obesity and established cardiovascular disease without diabetes.

Tirzepatide — a medication acting through GIP and GLP-1 receptors, administered once weekly. Clinical studies have shown significant weight reduction in patients with obesity or overweight with associated comorbidities.

These medications may have side effects, most commonly nausea, vomiting, constipation, diarrhoea, bloating and reduced appetite. Potential gallbladder problems, pancreatitis, dehydration, loss of muscle mass and interactions with other medications should also be considered.

Treatment should never be started independently, especially not with products obtained from unverified internet sources.

4. Endoscopic and Surgical Treatment Options

In patients with more severe obesity or significant obesity-related complications, metabolic or bariatric surgery may be considered. The most common procedures include sleeve gastrectomy and gastric bypass.

Bariatric surgery is not an “easy solution”, but a serious therapeutic option that requires careful assessment, preparation and long-term follow-up. After surgery, regular monitoring of nutritional status, vitamins, minerals, body composition and associated diseases is necessary.

Conclusion

Obesity is a serious medical condition that increases the risk of cardiovascular disease, diabetes, stroke, sleep apnoea, joint disease and certain cancers. The good news is that obesity can be treated.

Today, there are more therapeutic options than ever before: structured lifestyle modification, modern medications, endoscopic procedures and surgical treatment.

The best results are achieved when treatment is individualized, medically supervised and based on realistic goals with long-term follow-up. The aim is not only weight loss, but also reduction of health risk, better functional capacity, improved quality of life and protection of the heart.

Ordinacija Dr Mačkić provides an individualized approach to the assessment of cardiometabolic risk, with a special focus on prevention, cardiology evaluation and modern management of patients with obesity and associated risk factors. In our private praxis patients can also get help from nutrition Almir Azabagic MD.

References

Busetto, L., Dicker, D., Frühbeck, G. et al. (2024) ‘A new framework for the diagnosis, staging and management of obesity in adults’, Nature Medicine, 30, pp. 2395–2399. doi: 10.1038/s41591-024-03095-3.

Eisenberg, D., Shikora, S.A., Aarts, E. et al. (2022) ‘2022 American Society for Metabolic and Bariatric Surgery and International Federation for the Surgery of Obesity and Metabolic Disorders: Indications for metabolic and bariatric surgery’, Surgery for Obesity and Related Diseases, 18(12), pp. 1345–1356. doi: 10.1016/j.soard.2022.08.013.

European Medicines Agency (n.d.) Mounjaro: European public assessment report. Amsterdam: European Medicines Agency. Accessed: 9 July 2026.

European Medicines Agency (n.d.) Mysimba: European public assessment report. Amsterdam: European Medicines Agency. Accessed: 9 July 2026.

European Medicines Agency (n.d.) Saxenda: European public assessment report. Amsterdam: European Medicines Agency. Accessed: 9 July 2026.

European Medicines Agency (n.d.) Wegovy: European public assessment report. Amsterdam: European Medicines Agency. Accessed: 9 July 2026.

European Medicines Agency (n.d.) Xenical: European public assessment report. Amsterdam: European Medicines Agency. Accessed: 9 July 2026.

Koskinas, K.C., Van Craenenbroeck, E.M., Antoniades, C. et al. (2024) ‘Obesity and cardiovascular disease: an ESC clinical consensus statement’, European Heart Journal, 45(38), pp. 4063–4098. doi: 10.1093/eurheartj/ehae508.

Lincoff, A.M. et al. (2023) ‘Semaglutide and cardiovascular outcomes in obesity without diabetes’, The New England Journal of Medicine, 389(24), pp. 2221–2232. doi: 10.1056/NEJMoa2307563.

National Institute for Health and Care Excellence (2026) Overweight and obesity management. NICE guideline NG246. London: NICE. Accessed: 9 July 2026.

World Health Organization (2025) Obesity and overweight. Geneva: World Health Organization. Accessed: 9 July 2026.

On the occasion of the Echocardiography Masterclass with Prof. Thomas Binder held in Sarajevo, Dr Milan Gluhović, MD, MA, FESC, FHFA, Consultant Cardiologist, and Prof. Thomas Binder, one of Europe’s leading experts in echocardiography and cardiovascular imaging, appeared as guests on BHTV’s morning program “Jutro za sve.”

During the interview, they discussed how modern cardiology is rapidly evolving through the development of advanced imaging technologies, artificial intelligence and a more personalized approach to patient care.

Echocardiography – much more than an image

Dr Gluhović emphasized that modern echocardiography today represents much more than a traditional ultrasound examination of the heart.

With advanced techniques such as myocardial deformation imaging (strain analysis), 3D echocardiography and AI-supported solutions, physicians can evaluate cardiac function more precisely, detect abnormalities earlier and make better clinical decisions.

One of the key messages of contemporary cardiovascular imaging is:

“The goal is not only to see what the heart looks like, but to understand how the heart functions.”

Knowledge and education as the foundation of better medicine

Prof. Thomas Binder, an internationally recognized echocardiography expert and founder of the educational platform 123sonography, highlighted the importance of continuous medical education and the proper implementation of modern technologies into clinical practice.

Even the most advanced ultrasound systems and artificial intelligence tools can support physicians, but the quality of diagnosis still depends on medical knowledge, experience and correct interpretation of findings.

This was exactly the vision behind the Echocardiography Masterclass Sarajevo 2026 — an educational event created to improve practical echocardiography skills and bring advanced cardiovascular imaging closer to everyday clinical practice.

Sarajevo as a center for advanced cardiovascular imaging education

The Masterclass introduced a modern educational approach by combining expert lectures, real clinical cases and hands-on training using state-of-the-art ultrasound technologies.

Special focus was placed on some of the most important challenges in contemporary cardiology:

• heart failure
• valvular heart disease
• cardiomyopathies
• early detection of myocardial dysfunction
• implementation of artificial intelligence in cardiovascular imaging

Internistička ordinacija Dr Mačkić – bringing European standards of cardiovascular care closer to patients

The BHTV appearance and the organization of this international educational event represent a continuation of the mission of Internistička ordinacija Dr Mačkić:

to provide patients in Bosnia and Herzegovina with access to modern cardiovascular diagnostics based on European guidelines, advanced technology and continuous professional development.

Modern medicine begins with knowledge.

The best results are achieved when clinical expertise, innovation and technology come together with one common goal:

better care for every patient.

Sarajevo, June 6th, 2026

The Echocardiography Masterclass with Prof. Thomas Binder was successfully held in Sarajevo, bringing together physicians dedicated to advancing their knowledge and skills in modern echocardiography and cardiovascular imaging.

This unique educational event was designed with one clear goal:

less theory – more clinical mastery.

Through interactive lectures, real patient cases and intensive hands-on training, participants had the opportunity to learn advanced echocardiographic concepts directly from one of Europe’s leading experts in cardiovascular imaging.

It was a great honor to welcome Prof. Thomas Binder, internationally recognized cardiologist, echocardiography expert, educator and founder of 123sonography, whose educational work has inspired and trained thousands of physicians worldwide.

Bringing advanced echocardiography closer to everyday clinical practice

Modern echocardiography is no longer only about measuring cardiac dimensions or estimating ejection fraction.

Today, it represents a comprehensive clinical decision-making tool that helps physicians better understand cardiac function, detect disease earlier and provide more personalized patient care.

During the Masterclass, participants explored key areas of contemporary cardiovascular imaging:

• Heart failure assessment beyond ejection fraction
• Valvular heart disease evaluation
• Cardiomyopathies
• Myocardial deformation imaging (strain)
• 3D echocardiography
• Artificial intelligence in cardiovascular imaging
• Integration of imaging findings into clinical decision-making

The hands-on sessions provided a unique opportunity to work with advanced ultrasound technologies, including modern platforms with 3D imaging capabilities, automated measurements and AI-supported solutions.

Education. Innovation. Collaboration.

High-quality cardiovascular care begins with knowledge.

Standardization, continuous education and implementation of advanced technologies are essential steps toward improving diagnostic accuracy and patient outcomes.

The Echocardiography Masterclass Sarajevo represents an important milestone in the development of advanced cardiovascular imaging education in Bosnia and Herzegovina.

Internistička ordinacija Dr Mačkić – committed to excellence in cardiovascular medicine

At Internistička ordinacija Dr Mačkić, our mission is to bring together:

• clinical expertise
• evidence-based medicine
• continuous professional education
• state-of-the-art cardiovascular technology

Our goal is not only to answer the question:

“What does the heart look like?”

but more importantly:

“How does the heart function, and how can we prevent disease progression?”

We would like to express our sincere gratitude to Prof. Thomas Binder, all faculty members, participants and partners who contributed to making this Masterclass a success.

Together, we continue building a culture of knowledge, innovation and excellence in cardiovascular medicine.

#EchocardiographyMasterclass #ThomasBinder #Echocardiography #CardiovascularImaging #HeartFailure #ValvularHeartDisease #StrainImaging #3DEchocardiography #ArtificialIntelligence #POCUS #FOCUS #UltrasoundEducation #MedicalEducation
#ContinuousMedicalEducation #Cardiology #123sonography #SiemensHealthineers #ACUSONOrigin #InnovationInMedicine #FutureOfCardiology #Sarajevo #BosniaAndHerzegovina #DrMackic #MilanGluhovic

Correct blood pressure measurement is one of the most important steps in the prevention, detection and monitoring of arterial hypertension. Incorrectly measured blood pressure can lead to a wrong assessment of health status, unnecessary concern or inadequate treatment.

At Dr Mačkić Clinic, we often advise patients not to assess their blood pressure based on a single measurement, but on properly performed and recorded values over several days.

Why Is Correct Blood Pressure Measurement Important?

Blood pressure naturally changes throughout the day. It may increase due to stress, physical activity, coffee, smoking, pain, lack of sleep or improper body position during measurement.

For this reason, one isolated measurement is often not enough to diagnose hypertension. Home blood pressure monitoring helps the doctor get a more realistic picture of your cardiovascular risk and the effectiveness of your therapy.

Which Blood Pressure Monitor Should You Use?

For home blood pressure monitoring, an automatic digital blood pressure monitor with an upper-arm cuff is recommended.

Wrist blood pressure monitors may be less reliable if they are not used correctly, especially if the arm is not positioned at heart level. It is also very important to use the correct cuff size. A cuff that is too small may show falsely high values, while a cuff that is too large or loosely placed may give inaccurate results.

How to Prepare Before Measuring Blood Pressure

• Do not drink coffee, energy drinks or alcohol for at least 30 minutes before measurement.
• Do not smoke for at least 30 minutes before measurement.
• Do not exercise immediately before measurement.
• Empty your bladder before measuring your blood pressure.
• Sit quietly for at least 5 minutes before measurement.
• Do not talk during measurement.

Correct Body Position During Blood Pressure Measurement

• Sit upright with your back supported.
• Keep your feet flat on the floor.
• Do not cross your legs.
• Keep your arm relaxed and supported on a table.
• Place the cuff on a bare upper arm, not over clothing.
• Make sure the cuff is at heart level.

How to Measure Blood Pressure Correctly

After sitting properly and resting for a few minutes, place the cuff on your upper arm according to the manufacturer’s instructions. During the measurement, remain still, do not talk and do not move your arm.

It is recommended to take two measurements, 1 to 2 minutes apart, and record both values. If the values are significantly different, a third measurement may be taken, after which the average value can be calculated.

When Should You Measure Blood Pressure?

Blood pressure is most commonly measured in the morning and evening over several consecutive days.

• In the morning: before breakfast and before taking medication, unless your doctor has advised otherwise.
• In the evening: before bedtime or at approximately the same time each day.

It is important that measurements are taken under similar conditions, because this allows the doctor to interpret the results more accurately.

How to Keep a Blood Pressure Diary

Blood pressure values should be recorded in a diary or an app. Each entry should include:

• date and time of measurement
• systolic blood pressure, or the upper number
• diastolic blood pressure, or the lower number
• pulse
• notes about symptoms, therapy or stress, if present

This type of diary is very useful during a cardiology examination because it allows a more accurate assessment of blood pressure control.

What Are Normal Blood Pressure Values?

Optimal blood pressure is usually around 120/80 mmHg. Repeatedly elevated values require medical evaluation.

You should not draw conclusions based on one elevated reading, especially if you were upset, physically active or had recently consumed coffee. However, if elevated values occur repeatedly, you should contact your doctor.

When Should You Seek Urgent Medical Help?

If your blood pressure is very high, especially above 180/120 mmHg, repeat the measurement after a few minutes of rest.

Seek urgent medical help or contact emergency services if high blood pressure is accompanied by:

• chest pain
• shortness of breath
• weakness on one side of the body
• speech difficulties
• sudden blurred vision
• severe headache
• confusion or loss of consciousness

Common Mistakes When Measuring Blood Pressure

• measuring blood pressure immediately after physical activity
• measuring blood pressure after coffee or smoking
• talking during measurement
• crossing the legs
• keeping the arm below or above heart level
• placing the cuff over clothing
• using the wrong cuff size
• measuring too often, which can increase anxiety

Conclusion

Correct home blood pressure measurement helps with the early detection of hypertension, better therapy control and reduction of the risk of heart attack and stroke. The most important steps are using a reliable device, applying the correct technique and keeping an organized blood pressure diary.

If you have elevated blood pressure, blood pressure fluctuations, palpitations, headaches or you are already using hypertension therapy, at Dr Mačkić Clinic you can undergo a cardiology examination, ECG, heart ultrasound and additional cardiovascular risk assessment.

References

• 2024 ESC Guidelines for the management of elevated blood pressure and hypertension.
• American Heart Association: Home Blood Pressure Monitoring.
• Centers for Disease Control and Prevention: Measuring Your Blood Pressure Correctly.
• Parati G, Stergiou GS, Bilo G, et al. Home blood pressure monitoring: methodology, clinical relevance and practical application. Journal of Hypertension. 2010;28:1509–1527.
• Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults. Hypertension. 2018;71:e13–e115.

On Saturday, May 9, 2026, a professional workshop on POCUS ultrasound was held in Grude, organized by the Primary Health Care Center Grude, with the support of Bromabel, the official representative of Siemens Healthineers in Bosnia and Herzegovina.

The workshop was led by Mr Dr Milan Gluhović, specialist in internal medicine and cardiology, who provided participants with a practical and interactive introduction to the application of ultrasound at the point of care.

POCUS Ultrasound in Modern Clinical Practice

POCUS ultrasound, or Point-of-Care Ultrasound, is becoming an increasingly important part of daily clinical practice. It is especially valuable in primary care, emergency departments and outpatient settings, where fast and accurate assessment can support immediate clinical decision-making.

During the workshop, special emphasis was placed on the practical use of ultrasound in evaluating common clinical conditions such as dyspnea, chest pain, suspected heart failure, pleural effusion, free abdominal fluid and basic cardiac function.

Practical Training for Physicians from Herzegovina

Participants included physicians from primary care centers in the West Herzegovina Canton and the Herzegovina-Neretva Canton, giving the workshop an important regional dimension.

The training was specifically tailored for physicians working in primary health care, where rapid clinical assessment is crucial for proper patient management, timely referral and safer decision-making.

Hands-On Training with Siemens Ultrasound Technology

Thanks to the support of Bromabel, participants had the opportunity to work with advanced Siemens ultrasound systems and gain hands-on experience in realistic clinical scenarios.

The POCUS workshop was designed as a practical course with small-group training, live demonstrations and active participant involvement. This approach allowed physicians to directly practice ultrasound techniques relevant to everyday clinical work.

Key Topics Covered During the POCUS Workshop

The workshop focused on the most important POCUS applications for primary care and emergency assessment:

• FOCUS cardiac ultrasound – basic assessment of cardiac function, pericardial effusion and right ventricular size
• Lung ultrasound – identification of A-lines, B-lines, pleural effusion and ultrasound evaluation of dyspnea
• FAST protocol – rapid detection of free abdominal fluid in emergency situations
• POCUS in primary care – when and how ultrasound can support faster clinical decisions

Why POCUS Education Is Important in Primary Care

POCUS education is particularly valuable for family physicians, internists and emergency care providers. It can support faster triage, improve clinical assessment and help physicians make better decisions regarding further diagnostics, treatment and patient referral.

Introducing practical ultrasound training in primary care settings represents an important step toward modernizing healthcare delivery and strengthening diagnostic capabilities at the first point of patient contact.

Primary Health Care Center Grude as an Example of Best Practice

By organizing this workshop, the Primary Health Care Center Grude demonstrated a strong commitment to continuous medical education, the adoption of modern diagnostic methods and the improvement of patient care quality.

The POCUS workshop in Grude is a successful example of collaboration between a healthcare institution, a clinical expert and a company supporting the advancement of medical technology in Bosnia and Herzegovina.

Continuous Medical Education for Better Patient Care

The workshop held on May 9, 2026, in Grude confirmed the strong interest among physicians for practical and clinically applicable education programs.

Through this type of training, physicians gain valuable skills that can improve diagnostic accuracy, patient safety and the overall efficiency of the healthcare system.

Conclusion

The POCUS workshop in Grude provided physicians with practical knowledge in cardiac, lung and emergency ultrasound assessment. By bringing modern ultrasound education closer to primary care physicians, this training contributed to better clinical practice and improved patient care in the region.

Dr. Mačkić Clinic has made a major step forward in modern diagnostics by hosting a team from the international company Siemens Healthineers, who presented their latest premium ultrasound system, the ACUSON Origin AI – a state-of-the-art next-generation device based on advanced artificial intelligence (AI), designed primarily for cardiology diagnostics.

Advanced features presented during the Siemens team’s visit

During the demonstration at Dr. Mačkić Clinic, Siemens experts showed live how ACUSON Origin AI changes the way ultrasound examinations are performed:

• Automatic real-time image processing and analysis – the device independently recognizes structures and optimizes image contrast and clarity.
• AI algorithms for early detection of pathology – helping identify subtle pathological changes that can easily be missed by the naked eye.
• Significantly shorter examination time – automated measurements and predefined protocols reduce the number of necessary steps and keystrokes.
• Improved standardization of findings – each examination is more consistent, making it easier to compare results over time and between different physicians.
• Ergonomic design for physicians – comfortable operation and a logical control layout reduce fatigue and the risk of occupational injuries among sonographers.

Demonstration of the sophisticated AI system in operation

The largest global gathering of cardiologists, held in the heart of Madrid at the IFEMA congress center, brought together more than 35,000 participants from around the world.