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: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Whelton, Paul K.; Carey, Robert M.; Aronow, Wilbert S.; Casey, Donald E.; Collins, Karen J.; Himmelfarb, Cheryl Dennison; DePalma, Sondra M.; Gidding, Samuel S.; Jamerson, Kenneth; Jones, Daniel W.; MacLaughlin, Eric J.; Muntner, Paul; Ovbiagele, Bruce; Smith, Sidney C.; Spencer, Crystal C.; Stafford, Randall S.; Taler, Sandra J.; Thomas, Randal J.; Williams, Kim A.; Williamson, Jeff D.; Wright, Jackson T.

doi:10.1161/cir.0000000000000597

Cited by 1,034 publications

(1,468 citation statements)

References 360 publications

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“…2,37 The 2017 ACC has set a blood pressure reading above ≥130/80 mmhg to be considered hypertensive while the European Society of Hypertension guidelines have maintained a blood pressure reading of ≥140/90 mmhg to be considered to be hypertensive. 38,39 Since high BP is primarily asymptomatic, structured community programs play an important role in the diagnosis and have proven effective in diagnosis patients unaware they have hypertension. 40,41 3 | CURRENT EVIDENCE AND GUIDELINES Treatment of ISH in older adults was somewhat unclear until randomized studies such as the Systolic Hypertension in the Elderly Program (SHEP), 8 the Systolic Hypertension in Europe trial (Syst-Eur), 42 and the Hypertension in the Very Elderly Trial (HYVET) 43 showed significant CV benefits on lowering SBP in patients with ISH.…”

Section: Diagnosis Of Hypertensionmentioning

confidence: 99%

Hypertension in older adults: Assessment, management, and challenges

Oliveros

Patel

Kyung

et al. 2019

Clinical Cardiology

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288

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Hypertension in older adults is related to adverse cardiovascular outcomes, such as heart failure, stroke, myocardial infarction, and death. The global burden of hypertension is increasing due to an aging population and increasing prevalence of obesity, and is estimated to affect one third of the world's population by 2025. Adverse outcomes in older adults are compounded by mechanical hemodynamic changes, arterial stiffness, neurohormonal and autonomic dysregulation, and declining renal function. This review highlights the current evidence and summarizes recent guidelines on hypertension, pertaining to older adults. Management strategies for hypertension in older adults must consider the degree of frailty, increasingly complex medical comorbidities, and psycho‐social factors, and must therefore be individualized. Non‐pharmacological lifestyle interventions should be encouraged to mitigate the risk of developing hypertension, and as an adjunctive therapy to reduce the need for medications. Pharmacological therapy with diuretics, renin‐angiotensin system blockers, and calcium channel blockers have all shown benefit on cardiovascular outcomes in older patients. Given the economic and public health burden of hypertension in the United States and globally, it is critical to address lifestyle modifications in younger generations to prevent hypertension with age.

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Section: Diagnosis Of Hypertensionmentioning

confidence: 99%

Hypertension in older adults: Assessment, management, and challenges

Oliveros

Patel

Kyung

et al. 2019

Clinical Cardiology

Self Cite

288

149

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“…2 This figure widely varies according to socioeconomic factors. For example, in developed countries, such as the United States, hypertension control rate is 49.3 and 55.2% for men and women, respectively, 3 whereas in developing countries, that figure ranges from 1% (Mozambique) through 10.7% (Vietnam). 4 In Argentina, two studies in the general population were carried out in 2008 and 2015: RENATA 1 and RENATA 2.…”

Section: Introductionmentioning

confidence: 99%

Blood pressure control and cardiovascular risk profile in hypertensive patients under specialist care in Argentina: Results from the CHARTER study

Marín

Barochiner

Rodríguez

et al. 2019

J of Clinical Hypertension

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Worldwide, hypertension control rate is far from ideal. Some studies suggest that patients treated by specialists have a greater chance to achieve control. The authors aimed to determine the BP control rate among treated hypertensive patients under specialist care in Argentina, to characterize patients regarding their cardiovascular risk profile and antihypertensive drug use, and to assess the variables independently associated with adequate BP control. The authors included adult hypertensive patients under stable treatment, managed in 10 specialist centers across Argentina. Office BP was measured thrice with a validated oscillometric device. Adequate BP control was defined as an average of the three readings <140/90 mm Hg (and <150/90 in patients older than 80 years). The authors estimated the proportion of adequate BP control and the variables independently associated with it through a multiple conditional logistic regression model. Among the 1146 included patients, 48.2% were men with a mean age of 63.5 (±13.1) years old. Mean office BP was 135.3 (±14.8)/80.8 (±10) mm Hg, with a 64.8% (95% CI: 62%‐67.6%) of adequate control. The mean number of antihypertensive drugs was 2.1 per participant, the commonest being angiotensin receptor blockers and calcium channel blockers. In multivariable analysis, only female sex was a predictor of adequate BP control (OR 1.33 [95% CI 1.02‐1.72], P = .04). In conclusion, almost 65% of hypertensive patients treated in specialist centers in Argentina have adequate BP control. The challenge for future research is to define strategies in order to translate this control rate to the primary care level, where most patients are managed.

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“…adult population, and the prevalence increases with age. 3 Blood pressure (BP) control because of antihypertensive medications is associated with a decrease in cardiovascular morbidity and mortality. 4 However, despite antihypertensive medications being among the most commonly prescribed classes of medications in the United States, only about 50% of the hypertensive individuals achieve BP control.…”

Section: Gwas Of Beta-blocker Bp Responsementioning

confidence: 99%

Genomic Association Analysis Reveals Variants Associated With Blood Pressure Response to Beta‐Blockers in European Americans

Singh

Rouby

McDonough

et al. 2019

Clinical Translational Sci

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European Americans (EA) have a better antihypertensive response to β‐blockers when compared with African Americans, albeit with some variability. We undertook a genomewide association study to elucidate the underlying genetic determinants in EA contributing to this variability in blood pressure (BP) response. A discovery genomewide association study of change in BP post–metoprolol treatment was performed in EA participants (n = 201) from the Pharmacogenomic Evaluation of Antihypertensive Responses‐2 (PEAR‐2) study and tested for replication in the atenolol‐treated EA from the PEAR study (n = 233). Rs294610 in the FGD5, which encodes for FYVE, RhoGEF and PH Domain Containing 5, (expression quantitative trait loci for FGD5 in the small intestine) was significantly associated with increased diastolic BP response to β‐blockers in the PEAR‐2 study (P = 3.41 × 10−6, β = −2.70) and replicated (P = 0.01, β = −1.17) in the PEAR study. Post–meta‐analysis of these studies, an additional single nucleotide polymorphism rs45545233 in the SLC4A1, encoding for Solute Carrier Family 4 Member 1, (expression quantitative trait loci for dual specificity phosphatase 3 in the artery tibial) was identified that was significantly associated with a poor response to β‐blockers (P = 3.43 × 10−6, β = 4.57) and was replicated in the atenolol add‐on cohort (P = 0.007, β = 4.97). We identified variants in FGD5 and SLC4A1, which have been previously cited as candidate genes for hypertension, to be associated with a β‐blocker BP response in EA. Further elucidation is warranted of the underlying mechanisms of these variants and genes by which they influence the BP response to β‐blockers.

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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: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Cited by 1,034 publications

References 360 publications

Hypertension in older adults: Assessment, management, and challenges

Hypertension in older adults: Assessment, management, and challenges

Blood pressure control and cardiovascular risk profile in hypertensive patients under specialist care in Argentina: Results from the CHARTER study

Genomic Association Analysis Reveals Variants Associated With Blood Pressure Response to Beta‐Blockers in European Americans

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