Multivariate analysis of hypertension in general US adults based on the 2017 ACC/AHA guideline: data from the national health and nutrition examination survey 1999 to 2016

Wang, Dong; Hatahet, Mohamad; Wang, Yanning; Liang, Hong; Bazikian, Yvette; Bray, Christopher

doi:10.1080/08037051.2019.1593042

Cited by 7 publications

(8 citation statements)

References 26 publications

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“…12 Literature from various countries reported the prevalence of hypertension according to the 2017 ACC/AHA guideline. [13][14][15][16][17][18] Muntner et al 13 evaluated the effect of the 2017 ACC/AHA guideline on the prevalence of hypertension, and reported an increase of 13.7% in their adult population. Similarly, Kibria et al 14 18 assessed the changes in the prevalence of hypertension in the population of Nepal (aged ≥15 years) and Bangladesh (aged ≥35 years) and reported an increase of 23% and 22.3%, respectively.…”

Section: Introductionmentioning

confidence: 99%

Impact of the 2017 ACC/AHA guideline on the prevalence of elevated blood pressure and hypertension: a cross-sectional analysis of 10 799 individuals

et al. 2020

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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.

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Section: Introductionmentioning

confidence: 99%

Impact of the 2017 ACC/AHA guideline on the prevalence of elevated blood pressure and hypertension: a cross-sectional analysis of 10 799 individuals

et al. 2020

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“…e present results may also have been influenced by variation in BP levels, which might have led to patients being misclassified as hypertensive/normotensive. Elevated BP and/or the intake of BP-lowering drugs are used for hypertension diagnosis in many studies assessing the prevalence of hypertension in the general population [24,26]. ese studies did not consider the errors associated with the intake of BP-lowering drugs for reasons other than hypertension (angina, heart failure, history of myocardial infarction, peripheral artery disease) because the prevalence of these conditions is much lower than the prevalence of hypertension.…”

Section: Discussionmentioning

confidence: 99%

Trajectories of Blood Pressure in Patients with Established Coronary Artery Disease over 20 years

Jankowski

Kozieł

Bilo

et al. 2022

International Journal of Hypertension

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Objective. To evaluate changes in blood pressure (BP) values in patients with established coronary artery disease (CAD) over 20 years (1997–2017). Materials and Methods. Consecutive patients aged <71 years and hospitalized for acute coronary syndrome or myocardial revascularization procedures were recruited and interviewed 6–18 months after their discharge from the hospital. BP was measured in 1997–1998, 1999–2000, 2006–2007, 2011–2013, and 2016–2017. The same five hospitals took part in the surveys at each time point. Results. We examined 412 patients in 1997–1998, 427 in 1999–2000, 422 in 2006–2007, 462 in 2011–2013, and 272 in 2016–2017. The proportion of patients with BP at the recommended goal was 49.2% in 1997–98, 44.5% in 1999–2000, 44.7% in 2006–07, 51.1% in 2011–13, and 58.8% in 2016–17 ( p < 0.001 ). Mean systolic and diastolic BP decreased significantly independent of age, sex, and education (systolic BP: 137.9 ± 21.4 mmHg in 1997–98, 139.5 ± 21.6 mmHg in 1999–2000, 136.1 ± 20.3 mmHg in 2006–07, 134.8 ± 22.0 mmHg in 2011–13, and 134.2 ± 18.6 mmHg in 2016–17, p < 0.001 ; diastolic BP: 83.4 ± 11.0 mmHg in 1997–98, 84.8 ± 12.0 mmHg in 1999–2000, 85.2 ± 11.0 mmHg in 2006–07, 80.9 ± 12.5 mmHg in 2011–13, and 81.1 ± 10.4 mmHg in 2016–17; p < 0.001 ). Conclusion. The analysis of five multicenter surveys provides evidence of a decrease in BP in patients with established CAD over two decades. This trend is independent of age, sex, and the education level of the patients.

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“…Despite guideline recommendations, treatment rates for obesity (2.0-2.2% [26,27]) are significantly lower than those for other chronic diseases, such as hypertension (70.0−90.3% [28,29]) and hypercholesterolemia (with any cholesterol-lowering medication; 32.6−55.5% [28,30]), suggesting a poor diagnosis-to-treatment conversion rate and lack of a good shared decision-making process with patients. Furthermore, far fewer patients adhere to treatment with anti-obesity medications (AOMs) for 6 months or more than those using anti-hypertensive or cholesterol-lowering medications [31][32][33].…”

Section: R I P Tmentioning

confidence: 98%

Patient initiation and maintenance of GLP-1 RAs for treatment of obesity: a narrative review and practical considerations for primary care providers

Fitch

Ingersoll²

2020

Postgraduate Medicine

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Obesity is a chronic, relapsing metabolic disease, linked to a number of health risks and serious complications. Although highly prevalent in adults in the United States, it is underdiagnosed and untreated. Primary care providers (PCPs) are uniquely poised to diagnose and treat patients with obesity, using a selection of treatment strategies including lifestyle modifications and pharmacotherapies. As a physiological regulator of appetite and energy intake, the glucagon-like peptide-1 receptor agonist (GLP-1 RA) liraglutide 3.0 mg is approved for chronic weight management in individuals with overweight (pre-obesity) or obesity. In this review, we provide an overview of the clinical data supporting the use of liraglutide 3.0 mg, as well as practical advice for PCPs on the initiation and maintenance of treatment over the long-term. This also covers the management of side effects and how to manage patient expectations over time.

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Multivariate analysis of hypertension in general US adults based on the 2017 ACC/AHA guideline: data from the national health and nutrition examination survey 1999 to 2016

Cited by 7 publications

References 26 publications

Impact of the 2017 ACC/AHA guideline on the prevalence of elevated blood pressure and hypertension: a cross-sectional analysis of 10 799 individuals

Impact of the 2017 ACC/AHA guideline on the prevalence of elevated blood pressure and hypertension: a cross-sectional analysis of 10 799 individuals

Trajectories of Blood Pressure in Patients with Established Coronary Artery Disease over 20 years

Patient initiation and maintenance of GLP-1 RAs for treatment of obesity: a narrative review and practical considerations for primary care providers

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