Potential US Population Impact of the 2017 ACC/AHA High Blood Pressure Guideline
- PMID: 29133599
- PMCID: PMC5873602
- DOI: 10.1161/CIRCULATIONAHA.117.032582
Potential US Population Impact of the 2017 ACC/AHA High Blood Pressure Guideline
Abstract
Background: The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults provides recommendations for the definition of hypertension, systolic and diastolic blood pressure (BP) thresholds for initiation of antihypertensive medication, and BP target goals.
Objectives: This study sought to determine the prevalence of hypertension, implications of recommendations for antihypertensive medication, and prevalence of BP above the treatment goal among US adults using criteria from the 2017 ACC/AHA guideline and the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7).
Methods: The authors analyzed data from the 2011 to 2014 National Health and Nutrition Examination Survey (N = 9 623). BP was measured 3 times following a standardized protocol and averaged. Results were weighted to produce US population estimates.
Results: According to the 2017 ACC/AHA and JNC7 guidelines, the crude prevalence of hypertension among US adults was 45.6% (95% confidence interval [CI]: 43.6% to 47.6%) and 31.9% (95% CI: 30.1% to 33.7%), respectively, and antihypertensive medication was recommended for 36.2% (95% CI: 34.2% to 38.2%) and 34.3% (95% CI: 32.5% to 36.2%) of US adults, respectively. Nonpharmacological intervention is advised for the 9.4% of US adults with hypertension who are not recommended for antihypertensive medication according to the 2017 ACC/AHA guideline. Among US adults taking antihypertensive medication, 53.4% (95% CI: 49.9% to 56.8%) and 39.0% (95% CI: 36.4% to 41.6%) had BP above the treatment goal according to the 2017 ACC/AHA and JNC7 guidelines, respectively.
Conclusions: Compared with the JNC7 guideline, the 2017 ACC/AHA guideline results in a substantial increase in the prevalence of hypertension, a small increase in the percentage of US adults recommended for antihypertensive medication, and more intensive BP lowering for many adults taking antihypertensive medication.
Keywords: hypertension; prevalence; treatment.
© 2017 jointly by American College of Cardiology Foundation and American Heart Association. Published by Wolters Kluwer Health, Inc. All rights reserved.
Figures
Similar articles
-
Potential U.S. Population Impact of the 2017 ACC/AHA High Blood Pressure Guideline.J Am Coll Cardiol. 2018 Jan 16;71(2):109-118. doi: 10.1016/j.jacc.2017.10.073. Epub 2017 Nov 13. J Am Coll Cardiol. 2018. PMID: 29146532 Free PMC article.
-
Potential Cardiovascular Disease Events Prevented with Adoption of the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline.Circulation. 2019 Jan 2;139(1):24-36. doi: 10.1161/CIRCULATIONAHA.118.035640. Circulation. 2019. PMID: 30586736 Free PMC article.
-
Prevalence of ambulatory blood pressure phenotypes using the 2017 American College of Cardiology/American Heart Association blood pressure guideline thresholds: data from the Coronary Artery Risk Development in Young Adults study.J Hypertens. 2019 Jul;37(7):1401-1410. doi: 10.1097/HJH.0000000000002055. J Hypertens. 2019. PMID: 31145711 Free PMC article.
-
KDOQI US Commentary on the 2017 ACC/AHA Hypertension Guideline.Am J Kidney Dis. 2019 Apr;73(4):437-458. doi: 10.1053/j.ajkd.2019.01.007. Am J Kidney Dis. 2019. PMID: 30905361 Free PMC article. Review.
-
Blood pressure and the new ACC/AHA hypertension guidelines.Trends Cardiovasc Med. 2020 Apr;30(3):160-164. doi: 10.1016/j.tcm.2019.05.003. Epub 2019 May 15. Trends Cardiovasc Med. 2020. PMID: 31521481 Review.
Cited by
-
Branched-chain amino acids and the risk of hypertension; a persian cohort-based study.BMC Cardiovasc Disord. 2024 Jul 31;24(1):397. doi: 10.1186/s12872-024-04045-0. BMC Cardiovasc Disord. 2024. PMID: 39085768 Free PMC article.
-
Multiethnic Perspectives of Shared Decision-Making in Hypertension: A Mixed-Methods Study.J Am Heart Assoc. 2024 Jul 16;13(14):e032568. doi: 10.1161/JAHA.123.032568. Epub 2024 Jul 11. J Am Heart Assoc. 2024. PMID: 38989822 Free PMC article.
-
Investigating the Prevalence and Predictors of Uncontrolled Hypertension: A Cross-Sectional Study in Gujarat, India.Cureus. 2024 Apr 25;16(4):e59036. doi: 10.7759/cureus.59036. eCollection 2024 Apr. Cureus. 2024. PMID: 38800155 Free PMC article.
-
Dietary High Salt Intake Exacerbates SGK1-Mediated T Cell Pathogenicity in L-NAME/High Salt-Induced Hypertension.Int J Mol Sci. 2024 Apr 16;25(8):4402. doi: 10.3390/ijms25084402. Int J Mol Sci. 2024. PMID: 38673987 Free PMC article.
-
NETosis Drives Blood Pressure Elevation and Vascular Dysfunction in Hypertension.Circ Res. 2024 May 24;134(11):1483-1494. doi: 10.1161/CIRCRESAHA.123.323897. Epub 2024 Apr 26. Circ Res. 2024. PMID: 38666386 Free PMC article.
References
-
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults. J Am Coll Cardiol. 2017 - PubMed
-
- Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–72. - PubMed
-
- James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8) JAMA. 2014;311:507–20. - PubMed
-
- [Accessed September 7, 2004, 2004];NHANES 1999–2002 addendum to the NHANES III analytic guidelines. Available at http://www.cdc.gov/nchs/data/nhanes/guidelines1.pdf.
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical