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: 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.0000000000000596

Cited by 1,383 publications

(2,423 citation statements)

References 863 publications

Supporting

Mentioning

2,295

Contrasting

Unclassified

Order By: Relevance

“…The prevalence of hypertension in the PLWH cohort overall was 51.1% using this updated ACC/AHA definition 21 associations between hypertriglyceridemia and hypertension, we found inverse correlations between serum triglyceride and sys-…”

Section: Sensitivity Analysismentioning

confidence: 59%

“…Moreover, most of the studies evaluating the burden of hypertension among PLWH were performed before the recent American College of Cardiology/ American Heart Association revised definitions for hypertension with lower blood pressure thresholds. 21 The Evaluation of Vascular Event Risk while on Long-term Anti-retroviral Suppressive Therapy (EVERLAST) Study seeks to characterize the burden of cardiovascular risk among patients with HIV on cART in Ghana. We have shown in a recent report among Ghanaian PLWH that hypertension was associated with subclinical atherosclerosis at a carotid intimal media thickness (CIMT) cutoff value of 1.00 mm.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Characteristics of hypertension among people living with HIV in Ghana: Impact of new hypertension guideline

Nichols

Singh

Hardy

et al. 2019

J of Clinical Hypertension

Self Cite

View full text Add to dashboard Cite

Data on the burden of hypertension among people living with HIV (PLWH) in Africa are limited, especially after new expert consensus hypertension guidelines were published in 2017. The authors sought to assess the prevalence and factors associated with hypertension among PLWH. This is a cross‐sectional study involving PLWH on combination antiretroviral therapy (cART) (n = 250) compared with sex‐matched cART‐naïve PLWH (n = 201) in Ghana. Hypertension was defined as blood pressure ≥ 140/90 mm Hg or use of antihypertensive drugs. The authors also assessed the prevalence and predictors associated with hypertension using the recent guideline recommended cutoff BP ≥ 130/80 mm Hg. Multivariate logistic regression models were fitted to identify factors associated with hypertension among PLWH. The mean age of PLWH on cART was 45.7 ± 8.6 years, and 42.9 ± 8.8 years among PLWH cART‐naive with 81% of study participants being women. The prevalence of hypertension among PLWH on cART and PLWH cART‐naïve was 36.9% and 23.4%, P = 0.002 at BP ≥ 140/90 mm Hg and 57.2% and 42.3%, respectively, P = 0.0009, at BP ≥ 130/80 mm Hg. Factors associated with hypertension at BP ≥ 140/90 mm Hg in the PLWH group with adjusted odds ratio (95% CI) were increasing age, 2.08 (1.60‐2.71) per 10 years, and body mass index, 1.53 (1.24‐1.88) per 5 kg/m2 rise. At BP ≥ 130/80 mm Hg, cART exposure, aOR of 1.77 (95% CI: 1.20‐2.63), family history of hypertension, aOR of 1.43 (1.12‐1.83), and hypertriglyceridemia, aOR of 0.54 (0.31‐0.93), were associated with hypertension. Among PLWH, cART exposure was associated with higher prevalence of hypertension per the new guideline definition, a finding which warrants further investigation and possible mitigation.

show abstract

Section: Sensitivity Analysismentioning

confidence: 59%

mentioning

confidence: 99%

Characteristics of hypertension among people living with HIV in Ghana: Impact of new hypertension guideline

Nichols

Singh

Hardy

et al. 2019

J of Clinical Hypertension

Self Cite

View full text Add to dashboard Cite

show abstract

“…2 Moreover, the 2017 American College of Cardiology/American Heart Association hypertension lower threshold recommendations do not extend to the management of pregnancyrelated HTN. 35 In women with nonsevere PE or with GH, ACOG recommends measuring BP at least 2 times/week. Administering antihypertensive medication to women with mild to moderate pregnancy-related HTN is controversial, due to concerns of both efficacy and fetal safety.…”

Section: Management Of Pregnancy-related Htn-acog Recommendationsmentioning

confidence: 99%

Hypertension in pregnancy: Taking cues from pathophysiology for clinical practice

Sava

March

Pepine

2018

Clinical Cardiology

View full text Add to dashboard Cite

Pregnancy-related hypertension (PHTN) syndromes are a frequent and potentially deadly complication of pregnancy, while also negatively impacting the lifelong health of the mother and child. PHTN appears in women likely to develop hypertension later in life, with the stress of pregnancy unmasking a subclinical hypertensive phenotype. However, distinguishing between PHTN and chronic hypertension is essential for optimal management. Preeclampsia (PE) is linked to potentially severe outcomes and lacks effective treatments due to poorly understood mechanisms. Inadequate remodeling of spiral uterine arteries (SUAs), the cornerstone of PE pathophysiology, leads to hypoperfusion of the developing placenta. In normal pregnancies, extravillous trophoblast (EVT) cells assume an invasive phenotype and invade SUAs, transforming them into large conduits. Decidual natural killer cells play an essential role, mediating materno-fetal immune tolerance, inducing early SUA remodeling and regulating EVT invasiveness. Notch signaling is important in EVT phenotypic switch and is dysregulated in PE. The hypoxic placenta releases antiangiogenic and proinflammatory factors that converge upon maternal endothelium, inducing endothelial dysfunction, hypertension, and organ damage.Hypoxia-inducible factor 1-α is upstream of such molecules, whereas endothelin-1 is a major effector. We also describe important genetic links and evidence of incomplete materno-fetal immune tolerance, with PE patients presenting with autoantibodies, lower T reg , and higher T h 17 cells. Thus, PE manifestations arise as a consequence of mal-placentation or/and because of a predisposition of the maternal vascular bed to excessively react to pathogenic molecules.From this pathophysiological basis, we provide current and propose future therapeutic directions for PE.

show abstract

“…Blood pressure was measured after ≥5 min of supine rest using manual or automated (Dinamap) sphygmomanometry by a well-trained researcher. In accordance with AHA-guidelines, blood pressure was measured at least twice and averaged (Whelton et al 2017). Fasting total cholesterol, HDL cholesterol, low-density lipoprotein (LDL) cholesterol, and glucose were measured at accredited clinical laboratory facilities.…”

Section: Subject Characteristicsmentioning

confidence: 99%

Improvements in fitness are not obligatory for exercise training-induced improvements in CV risk factors

et al. 2018

View full text Add to dashboard Cite

The purpose of this study was to assess whether changes in physical fitness relate to changes in cardiovascular risk factors following standardized, center‐based and supervised exercise training programs in subjects with increased cardiovascular risk. We pooled data from exercise training studies of subjects with increased cardiovascular risk (n = 166) who underwent 8–52 weeks endurance training. We determined fitness (i.e., peak oxygen uptake) and traditional cardiovascular risk factors (body mass index, blood pressure, total cholesterol, high‐density lipoprotein cholesterol), before and after training. We divided subjects into quartiles based on improvement in fitness, and examined whether these groups differed in terms of risk factors. Associations between changes in fitness and in cardiovascular risk factors were further tested using Pearson correlations. Significant heterogeneity was apparent in the improvement of fitness and individual risk factors, with nonresponder rates of 17% for fitness, 44% for body mass index, 33% for mean arterial pressure, 49% for total cholesterol, and 49% for high‐density lipoprotein cholesterol. Neither the number, nor the magnitude, of change in cardiovascular risk factors differed significantly between quartiles of fitness change. Changes in fitness were not correlated with changes in cardiovascular risk factors (all P > 0.05). Our data suggest that significant heterogeneity exists in changes in peak oxygen uptake after training, while improvement in fitness did not relate to improvement in cardiovascular risk factors. In subjects with increased cardiovascular risk, improvements in fitness are not obligatory for training‐induced improvements in cardiovascular risk factors.

show abstract

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

Cited by 1,383 publications

References 863 publications

Characteristics of hypertension among people living with HIV in Ghana: Impact of new hypertension guideline

Characteristics of hypertension among people living with HIV in Ghana: Impact of new hypertension guideline

Hypertension in pregnancy: Taking cues from pathophysiology for clinical practice

Improvements in fitness are not obligatory for exercise training-induced improvements in CV risk factors

Contact Info

Product

Resources

About