Potential U.S. Population Impact of the 2017 ACC/AHA High Blood Pressure Guideline

Paul Muntner, Robert M. Carey, Samuel Gidding, Daniel W. Jones, Sandra J Taler, Jackson T. Wright, Paul K. Whelton

Research output: Contribution to journalArticle

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 U.S. 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 U.S. population estimates. Results According to the 2017 ACC/AHA and JNC7 guidelines, the crude prevalence of hypertension among U.S. 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 U.S. adults, respectively. Nonpharmacological intervention is advised for the 9.4% of U.S. adults with hypertension who are not recommended for antihypertensive medication according to the 2017 ACC/AHA guideline. Among U.S. 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 U.S. adults recommended for antihypertensive medication, and more intensive BP lowering for many adults taking antihypertensive medication.

Original languageEnglish (US)
Pages (from-to)109-118
Number of pages10
JournalJournal of the American College of Cardiology
Volume71
Issue number2
DOIs
StatePublished - Jan 16 2018

Fingerprint

American Heart Association
Cardiology
Antihypertensive Agents
Guidelines
Blood Pressure
Hypertension
Confidence Intervals
Population
Nutrition Surveys

Keywords

  • hypertension
  • prevalence
  • treatment

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Potential U.S. Population Impact of the 2017 ACC/AHA High Blood Pressure Guideline. / Muntner, Paul; Carey, Robert M.; Gidding, Samuel; Jones, Daniel W.; Taler, Sandra J; Wright, Jackson T.; Whelton, Paul K.

In: Journal of the American College of Cardiology, Vol. 71, No. 2, 16.01.2018, p. 109-118.

Research output: Contribution to journalArticle

Muntner, Paul ; Carey, Robert M. ; Gidding, Samuel ; Jones, Daniel W. ; Taler, Sandra J ; Wright, Jackson T. ; Whelton, Paul K. / Potential U.S. Population Impact of the 2017 ACC/AHA High Blood Pressure Guideline. In: Journal of the American College of Cardiology. 2018 ; Vol. 71, No. 2. pp. 109-118.
@article{221068d302d34439a08e820234eabe61,
title = "Potential U.S. 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 U.S. 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 U.S. population estimates. Results According to the 2017 ACC/AHA and JNC7 guidelines, the crude prevalence of hypertension among U.S. 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 U.S. adults, respectively. Nonpharmacological intervention is advised for the 9.4{\%} of U.S. adults with hypertension who are not recommended for antihypertensive medication according to the 2017 ACC/AHA guideline. Among U.S. 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 U.S. adults recommended for antihypertensive medication, and more intensive BP lowering for many adults taking antihypertensive medication.",
keywords = "hypertension, prevalence, treatment",
author = "Paul Muntner and Carey, {Robert M.} and Samuel Gidding and Jones, {Daniel W.} and Taler, {Sandra J} and Wright, {Jackson T.} and Whelton, {Paul K.}",
year = "2018",
month = "1",
day = "16",
doi = "10.1016/j.jacc.2017.10.073",
language = "English (US)",
volume = "71",
pages = "109--118",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "2",

}

TY - JOUR

T1 - Potential U.S. Population Impact of the 2017 ACC/AHA High Blood Pressure Guideline

AU - Muntner, Paul

AU - Carey, Robert M.

AU - Gidding, Samuel

AU - Jones, Daniel W.

AU - Taler, Sandra J

AU - Wright, Jackson T.

AU - Whelton, Paul K.

PY - 2018/1/16

Y1 - 2018/1/16

N2 - 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 U.S. 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 U.S. population estimates. Results According to the 2017 ACC/AHA and JNC7 guidelines, the crude prevalence of hypertension among U.S. 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 U.S. adults, respectively. Nonpharmacological intervention is advised for the 9.4% of U.S. adults with hypertension who are not recommended for antihypertensive medication according to the 2017 ACC/AHA guideline. Among U.S. 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 U.S. adults recommended for antihypertensive medication, and more intensive BP lowering for many adults taking antihypertensive medication.

AB - 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 U.S. 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 U.S. population estimates. Results According to the 2017 ACC/AHA and JNC7 guidelines, the crude prevalence of hypertension among U.S. 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 U.S. adults, respectively. Nonpharmacological intervention is advised for the 9.4% of U.S. adults with hypertension who are not recommended for antihypertensive medication according to the 2017 ACC/AHA guideline. Among U.S. 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 U.S. adults recommended for antihypertensive medication, and more intensive BP lowering for many adults taking antihypertensive medication.

KW - hypertension

KW - prevalence

KW - treatment

UR - http://www.scopus.com/inward/record.url?scp=85040548880&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040548880&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2017.10.073

DO - 10.1016/j.jacc.2017.10.073

M3 - Article

VL - 71

SP - 109

EP - 118

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 2

ER -