Clinical Implications of the 2017 ACC/AHA Hypertension Guidelines

Tiwana, Jasleen; Yang, Eugene

doi:10.1093/eurheartj/ehz423

“…Moreover, a major shift from 2003 JNC7 guideline is the highest absolute increase proportion of hypertension grade II and highest increase rate of hypertension grade III using the new de nition of hypertension grades. As pharmacologic treatment is recommended for hypertension grade I only if one accompanied with 10-year ASCVD risk ≥ 10% 9 , the 2017 ACC/AHA guideline may has signi cant implication for hypertension treatment population, especially among adults with hypertension grade II and III. In addition, another major shift from 2003 JNC7 guideline is the obviously increasing of the proportion of IDH and SDH among all adults with hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…The 2017 ACC/AHA hypertension guideline recommends using a systolic BP (SBP) ≥ 130 mmHg or a diastolic BP (DBP) ≥ 80 mmHg to de ne hypertension, in contrast to a SBP ≥ 140 mmHg or DBP ≥ 90 mmHg that was used to de ne hypertension in guideline of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7) in 2003 7 . This major shift has major implications for an entity known as isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), systolic-diastolic hypertension (SDH), Stage 1 hypertension and Stage 2 hypertension 8, 9 .…”

Section: Introductionmentioning

confidence: 99%

Trends difference in prevalence of hypertension subtypes and hypertension control in US adults as defined by 2017 ACC/AHA Guideline and 2003 JNC7 Guideline

Huang,

Du,

Tang

et al. 2023

Preprint

0

View full text Add to dashboard Cite

This study sought to compare the trends difference in prevalence of hypertension subtypes and hypertension control in US adults, by 2017 ACC/AHA and 2003 JNC7 guidelines. Serial cross-sectional analysis of National Health and Nutrition Examination Survey data of U.S. adults with hypertension from 1999–2000 to 2017–2018 were included. Hypertension was defined with two guidelines and BP control among those with hypertension was determined by the two guidelines respectively. Hypertension grades, hypertension subtypes and hypertension accompanied with other diseases were also analyzed. A total of 22371 and 17411 participants meet the diagnostic criteria of 2017 ACC/AHA guideline and 2003 JNC7 guideline, respectively in the current study. Among all adults included in the analysis, the crude percentage of hypertension grades, hypertension subtypes and hypertension with other accompanying disease or risk (10-year predicted cardiovascular disease risk ≥ 10%, CVD history, diabetes, CKD) defined by the 2017 ACC/AHA guideline were all higher than those based on the 2003 JNC7 guideline. Among all adults with hypertension, the proportion of taking antihypertensive medication increased from 44.5% in 1999–2000 to 58.5% in 2017–2018 according to the 2017 ACC/AHA guideline compared with 60% in 1999–2000 to 74.5% in 2017–2018 according to the 2003 JNC7 guideline. Among all adults with hypertension accompanied with other diseases, hypertension with 10-year predicted cardiovascular disease risk ≥ 10% showed lowest proportion of taking antihypertensive medication, which increased from 54.9% in 1999–2000 to 69.7% in 2017–2018 and 65.7% in 1999–2000 to 79.2% in 2017–2018 based on the 2017 ACC/AHA guideline and the 2003 JNC7 guideline, respectively. The proportion of controlled BP based on the 2003 JNC7 guideline showed higher than those based on the 2017 ACC/AHA guideline and both of them revealed the similar trend. Compared with the 2003 JNC7 guideline, the 2017 ACC/AHA guideline result in increasing in both the proportion of hypertension, hypertension grades and hypertension subtypes among all adults with hypertension, and decreasing the proportion of hypertension accompanied with other diseases, the proportion of taking antihypertensive medication among all adults with hypertension, hypertension grades, hypertension subtypes or hypertension accompanied with other diseases, and the proportion of controlled BP among taking antihypertensive medication with hypertension and hypertension accompanied with 10-year ASCVD risk ≥ 10% and CVD history.

show abstract

“…For proper management of hypertension, pharmacological and non-pharmacological interventions are needed (4). Among non-pharmacologic therapies, following dietary approach to stop hypertension (DASH) is emphasized as primary interventions for all adults with increased blood pressure (5).…”

Section: Introductionmentioning

confidence: 99%

Diettary Approach to Stop Hypertension Adherence and Associated Factor Among Individuals With Hypertension in West Gojjam Zone Public Hospitals, North West Ethiopia, 2023:mixed approach

Asmare,

Mengistu,

Desalegn

et al. 2024

Preprint

0

View full text Add to dashboard Cite

Background; - Hypertension is a major public health concern with a higher contribution to world morbidity and mortality. DASH diet adherence is key to maintain blood pressure levels and prevent its complications but in Ethiopia, there is a limited evidence about its adherence. This research explores the DASH diet adherence and fill knowledge gaps. Objective;-The aim of this study was to identify DASH diet adherence and associated factors and explore barriers and contributing factors among individuals with hypertension in West Gojjam Zone public hospitals, Northwest Ethiopia, 2023. Method; - A cross-sectional study supplemented with a qualitative approach was used among 582 participants. A systematic random sampling and purposeful sampling technique were used for participant selection. Epi Info version 7.5 for data entry and STATA 17 for analysis were used. Open Code 4.2 was used for thematic analysis of qualitative data. In bivariable analysis, a p value of 0.2 was entered into multivariable analysis. Crude odd ratio (COR) and then an adjusted odds ratio (AOR) at 95% CI was also used to measure the strength, and the significance of the variable was declared at a p value of ≤0.05. Result; - The overall proportion of good DASH diet adherence of the study was 40.7% [CI; 36.65, 44.7]). A multivariable logistic regression showed that who had good knowledge about hypertension (AOR=2.54, CI: [1.66-3.88]), Strong social support(AOR=3.4, CI: [1.12, 4.4]), presence of co- comorbidity( AOR=2, CI;[1.71, 4.52]), presence of family history (AOR1=3, CI; [1.37, 7.0]) and diagnosis duration of HTN >10 years(AOR;3.3 CI;[1.1, 9.8]) and 5-10 years(AOR=2.38, CI;[1.23, 4.55]) were significantly associated with good DASH diet adherence. Economic problem, lack of family support, working condition, inaccessibility of the diet and social life were also a barrier for good adherence. Conclusion; this study has revealed that only two-fifths of respondents had with good DASH diet adherence. Good knowledge for hypertension, presence of family history, presence of comorbidity, strong social support, and long duration of hypertension diagnosis were significantly associated with DASH diet adherence. Financial problems, the inaccessibility of diet, working condition, social life interactions, and the absence of family support were barriers to good adherence. Nutritional education, increasing production of fruit and vegetables are recommended.

show abstract

“…For proper management of hypertension, pharmacological and non-pharmacological interventions are needed(4). Among non-pharmacologic therapies, following dietary approach to stop hypertension (DASH) is emphasized as primary interventions for all adults with increased blood pressure (5).…”

Section: Introductionmentioning

confidence: 99%

Dietary Approach to Stop Hypertension Adherence and Associated Factors Among Individuals With Hypertension In West Gojjam Zone Public Hospitals, North West Ethiopia, 2023: Mixed Approach.

Asmare,

Mengistu,

Desalegn

et al. 2024

Preprint

0

View full text Add to dashboard Cite

Background; - Hypertension is a major public health concern with a higher contribution to world morbidity and mortality. DASH diet adherence is key to maintain blood pressure levels and prevent its complications but in Ethiopia, there is a limited evidence about its adherence. This research explores the DASH diet adherence and fill knowledge gaps. Objective;-The aim of this study was to identify DASH diet adherence and associated factors and explore barriers and contributing factors among individuals with hypertension in West Gojjam Zone public hospitals, Northwest Ethiopia, 2023. Method; - A cross-sectional study supplemented with a qualitative approach was used among 582 participants. A systematic random sampling and purposeful sampling technique were used for participant selection. Epi Info version 7.5 for data entry and STATA 17 for analysis were used. Open Code 4.2 was used for thematic analysis of qualitative data. In bivariable analysis, a p value of 0.2 was entered into multivariable analysis. Crude odd ratio (COR) and then an adjusted odds ratio (AOR) at 95% CI was also used to measure the strength, and the significance of the variable was declared at a p value of ≤0.05. Result; - The overall proportion of good DASH diet adherence of the study was 40.7% [CI; 36.65, 44.7]). A multivariable logistic regression showed that who had good knowledge about hypertension (AOR=2.54, CI: [1.66-3.88]), Strong social support(AOR=3.4, CI: [1.12, 4.4]), presence of co- comorbidity( AOR=2, CI;[1.71, 4.52]), presence of family history (AOR1=3, CI; [1.37, 7.0]) and diagnosis duration of HTN >10 years(AOR;3.3 CI;[1.1, 9.8]) and 5-10 years(AOR=2.38, CI;[1.23, 4.55]) were significantly associated with good DASH diet adherence. Economic problem, lack of family support, working condition, inaccessibility of the diet and social life were also a barrier for good adherence. Conclusion; this study has revealed that only two-fifths of respondents had with good DASH diet adherence. Good knowledge for hypertension, presence of family history, presence of comorbidity, strong social support, and long duration of hypertension diagnosis were significantly associated with DASH diet adherence. Financial problems, the inaccessibility of diet, working condition, social life interactions, and the absence of family support were barriers to good adherence. Nutritional education, increasing production of fruit and vegetables are recommended.

show abstract

Clinical Implications of the 2017 ACC/AHA Hypertension Guidelines

Cited by 3 publications

References 0 publications

Trends difference in prevalence of hypertension subtypes and hypertension control in US adults as defined by 2017 ACC/AHA Guideline and 2003 JNC7 Guideline

Trends difference in prevalence of hypertension subtypes and hypertension control in US adults as defined by 2017 ACC/AHA Guideline and 2003 JNC7 Guideline

Diettary Approach to Stop Hypertension Adherence and Associated Factor Among Individuals With Hypertension in West Gojjam Zone Public Hospitals, North West Ethiopia, 2023:mixed approach

Dietary Approach to Stop Hypertension Adherence and Associated Factors Among Individuals With Hypertension In West Gojjam Zone Public Hospitals, North West Ethiopia, 2023: Mixed Approach.

Contact Info

Product

Resources

About