ObjectivesTo assess the effect of the 2017 American College of Cardiology and the American Heart Association (ACC/AHA) hypertension guideline on the prevalence of elevated blood pressure (BP) and hypertension and the initiation of antihypertensive treatment, as well as the level of adherence to the BP target in the Saudi population.DesignA cross-sectional study.ParticipantsA total of 10 799 adults (≥18 years old), with three BP readings during 2017–2020 from the Saudi Biobank was used.Primary outcomeHypertension was defined using three sources: the Joint National Committee 7 Blood Pressure Guideline (JNC-7) guideline (systolic BP (SBP)≥140 or diastolic BP (DBP)≥90 mm Hg), the 2017 ACC/AHA guideline (SBP≥130 or DBP≥80 mm Hg) and a self-reported hypertension diagnosis.ResultsThe prevalence of hypertension, according to the JNC-7 guideline, was 14.49% (95% CI 14.37 to 14.61), and the 2017 ACC/AHA, 40.77% (95% CI 40.60 to 40.94), a difference of 26.28%. Antihypertensive medication was recommended for 24.84% (95% CI 24.69 to 24.98) based on the JNC-7 guideline and 27.67% (95% CI 27.52 to 27.82) using the 2017 ACC/AHA guideline. Lifestyle modification was recommended for 13.10% (95% CI 12.47 to 13.74) of patients with hypertension who were not eligible for a pharmacological intervention, based on the 2017 ACA/AHA guideline. For patients with prescribed antihypertensive medication, 49.56% (95% CI 45.50 to 53.64) and 27.81% (95% CI 24.31 to 31.59) presented with a BP reading above the treatment goal, based on the 2017 ACA/AHA and JNC-7 guidelines, respectively. Using the two definitions, the risk factors were older age, male gender, diabetes diagnosis, increased body mass index, waist circumference and waist-to-hip ratio.ConclusionsAccording to the 2017 ACC/AHA guideline, the prevalence of hypertension has increased significantly, but there was only a small increase in the proportion of patients recommended for antihypertensive treatment. A large proportion of patients with prescribed antihypertensive medication, had a BP above the target. Unless public health prevention efforts are adopted, the increased prevalence of elevated BP and hypertension will increase cardiovascular disease.

Background: The COVID-19 pandemic has had a negative impact on overall health and well-being. Therefore, certain preventive measures may affect many lifestyle habits. This study aimed to explore the eating habits, food variety score (FVS), and diet diversity score (DDS) of adults residing in Saudi Arabia during the mandatory stay-at-home advisory for COVID-19. Methods: A cross sectional study was targeted adults living in Saudi Arabia during the COVID-19 lockdown (May – June 2020). An electronic self-reported survey was conducted through Research Electronic Data Capture (Redcap) distributed on social media platforms. The Arabic version of the questionnaire was previously evaluated for its reliability and validity. A total of 359 individuals who completed the food frequency questionnaire were included in the study. Diet diversity score (DDS) and food variety score (FVS) was calculated. Results: The study found that the distribution of FVS ranged between 4-27 food items. The distribution of DDS ranged between 3-14 food items. Income, working status, and living status were factors associated with the FVS and/or DDS. The majority of the cohort (>67%) had at least one snack/day and < 3 meals/day. Conclusion: Diet diversity was acceptable among Saudi adults during the COVID-19 lockdown period. Age, sex, having children, marital status, education level, and income were factors associated with diet diversity and eating habits (having breakfast, skipping meals, and number of snacks).