Estimating the Association of the 2017 and 2014 Hypertension Guidelines With Cardiovascular Events and Deaths in US Adults

Bundy, Joshua D; Mills, Katherine T.; Chen, Jing; Li, Changwei; Greenland, Philip; He, Jiang

doi:10.1001/jamacardio.2018.1240

Cited by 93 publications

(72 citation statements)

References 44 publications

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“…Several cohort studies indicated a positive association of increased mortality risk with low SBP level (<120 mm Hg/90 mm Hg) or low DBP level (<80 mm Hg/40 mm Hg): the Korean Cancer Prevention Study, with 22.7 million person years of follow-up, which included 1,329,525 people aged 30 to 95 (2); a retrospective community-based cohort study of 128,765 Taiwanese people aged 65 or older followed for 3 years (4); and a prospective cohort study of 4,658 Chinese people aged 65 to 99 followed for 3 years (8). Other cohort studies suggested increased mortality risk with high SBP level (≥120 mm Hg/160 mm Hg), high DBP level (≥90 mm Hg), or SBP/DBP ≥120/80 mm Hg, 140/90 mm Hg, 160/ 100 mm Hg (2,5,6,9,26,27).…”

Section: Discussionmentioning

confidence: 99%

“…To avoid potential bias and confirm primary findings, we performed additional sensitivity analyses because of a rapid decrease in strength of the blood pressure-mortality association during the early follow-up period (25); study participants who had died during the first 2 years of follow-up (n = 143) were excluded from analyses. We further excluded participants with myocardial infarction, heart failure, stroke, diabetes mellitus, or cancer at baseline (n = 1,314) because these diseases could have affected blood pressure and thus the blood pressure-mortality relationship (2,26). All analyses were adjusted at baseline examination for age; marital status; mean individual income (monthly); education level; smoking; drinking; physical activity; BMI; total cholesterol; triglycerides; HDL-C; LDL-C; fasting plasma glucose; family history of hypertension, diabetes mellitus, or hyperlipidemia; and use of hypoglycemic and lipid-lowering medications.…”

Section: Statistical Analysesmentioning

confidence: 99%

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Sex-Specific Association of Blood Pressure Categories With All-Cause Mortality: The Rural Chinese Cohort Study

et al. 2020

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What is already known on this topic? Increased risk of all-cause mortality is associated with nonoptimal blood pressure. However, studies of the relationship between blood pressure categories and all-cause mortality in the Chinese adult population are limited, and sex-specific studies of these associations are not available. Furthermore, the relationship between the 2017 US hypertension guidelines and all-cause mortality in China is unclear. What is added by this report? Results of our prospective study, in a rural Chinese population, showed that risk of all-cause mortality with hypertension based on the 2017 US hypertension guidelines was increased for men but not women. What are the implications for public health practice? Treatment for hypertension should rely on clinicians' cautious judgment about whether and when to start treatment. In addition, antihypertension goals may need to be individualized for people with different characteristics.

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Section: Discussionmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

Sex-Specific Association of Blood Pressure Categories With All-Cause Mortality: The Rural Chinese Cohort Study

et al. 2020

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“…Accumulating evidence has shown that reduction of systolic BP to a target of < 130 mmHg significantly decreases the risk of myocardial infarction, stroke, heart failure and major cardiovascular events in adults (2). Implementation of the 2017/ACC/AHA hypertension guideline is, therefore, expected to translate into reduction in cardiovascular mortality and morbidity (3). However, compared to JNC7, the new lower 2017/ACC/AHA diagnostic thresholds will increase the disease burden worldwide, annual costs of antihypertensive treatment, the proportion of uncontrolled hypertensives, (3)(4)(5)(6), and likely the number of adverse events among treated patients (3).…”

Section: Introductionmentioning

confidence: 99%

“…Implementation of the 2017/ACC/AHA hypertension guideline is, therefore, expected to translate into reduction in cardiovascular mortality and morbidity (3). However, compared to JNC7, the new lower 2017/ACC/AHA diagnostic thresholds will increase the disease burden worldwide, annual costs of antihypertensive treatment, the proportion of uncontrolled hypertensives, (3)(4)(5)(6), and likely the number of adverse events among treated patients (3). Decreasing the diagnostic thresholds for hypertension is also expected to increase the number of statin-eligible adults according to the 2016 cholesterol guideline (7).…”

Section: Introductionmentioning

confidence: 99%

Impact of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline on the prevalence of hypertension in young Saudi women

Al-Mohaissen

Al-Obaid

AlGhamdi

et al. 2020

East Mediterr Health J

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Background: The diagnostic criteria for hypertension have recently been redefined by the American College of Cardiology/American Heart Association (ACC/AHA). Data on the new prevalence of hypertension in different countries are emerging, but none, to date, from Saudi Arabia. Aim: This study aimed to determine the impact of the 2017 ACC/AHA hypertension guideline on the prevalence and determinants of hypertension in young Saudi women. Methods: 518 female college students, 17-29 years of age were prospectively enrolled in a survey during the period from January 1, 2016, to April 15, 2016 at Princess Nourah University. The participants completed a previously validated questionnaire, that assessed their risk factors for hypertension, and their blood pressure, weight and height were measured. Results: Application of the 2017 ACC/AHA diagnostic criteria resulted in approximately 7-fold increase in the prevalence of hypertension, from 4.1% to 27.1% (P < 0.001). At a cutoff value of ≥140/90, hypertension was significantly associated with increased age, increased body mass index (BMI), increased heart rate, history of chronic illnesses, prior diagnosis with diabetes mellitus and family history of hypertension. Whereas, with the ≥130/80 cutoff value, only increased BMI and heart rate were significant predictors (P < 0.001).

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“…To be noticed, the American College of Cardiology/AHA released a guideline in 2017 and lowered the thresholds of defining hypertension, 122 which in turn greatly raised the prevalence and hypertension-related CVD burden. 123 Thus, our findings underscored the importance of dietary pattern and BP promotion in improving the overall CVH status and reducing the related CVD burden. We reported that 51.7%, 40.6% and 40.3% of participants were having ideal TC, physical activity, and BMI.…”

Section: Discussionmentioning

confidence: 54%

Cardiovascular health status and its associations with cardiovascular disease and ischemic heart disease prevalence in Australian adults

Yang

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BackgroundCardiovascular disease (CVD) and ischemic heart disease (IHD) are two major health burdens. It has been suggested that the improvement of modifiable lifestyle factors could substantially reduce the CVD and IHD risk. To define and monitor the cardiovascular health (CVH) status in the general population, the American Heart Association has outlined seven modifiable lifestyle-related factors [smoking, body mass index (BMI), physical activity, dietary pattern, total cholesterol (TC), blood pressure (BP), and fasting plasma glucose (FPG)] and they were also called Life's Simple 7. A number of studies have measured the CVH status and explored its association with CVD/IHD risk.However, very few studies have used Life's Simple 7 in Australian adults. MethodsFirstly, we conducted two systematic reviews to estimate the CVH status and explore the association between the CVH status and CVD/IHD related events in adults worldwide. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials and relevant articles published between 2010 and 2018.Secondly, we used the core sample of the 2011-2012 Australian Health Survey and included 7499 adults (≥ 18 years) with available TC and FPG tests. We estimated the proportions of ideal status for the seven CVH metrics and the prevalence of overall poor (having 0-2 ideal CVH metrics) and ideal (having 5-7 ideal CVH metrics) CVH status in the overall Australians and sex/age subpopulations. In addition, we explored the associations between the ideal status of individual metrics, using Poisson regression analysis and population attributable fractions, and overall CVH status, using logistic regression analysis, on the CVD and IHD prevalence in the overall Australians and sex/age subpopulations. ResultsThe first systematic review indicated that FPG has the highest proportion of ideal status (69.1%) whereas the dietary pattern has the lowest (12.1%) for adults worldwide. 32.2% and 19.6% of adults have overall poor and ideal CVH status. Compared to males and older adults (≥ 60 years), females and younger adults (< 60 years) have lower proportions of the overall poor CVH status and higher proportions of ideal status for most CVH metrics and the overall ideal CVH status. The CVH status has improved over study time and there may exist regional variations in CVH status. The second systematic review suggested that a higher number of ideal CVH metrics was associated with a IV Publications included in this thesis 1. Peng Y, Cao S, Yao Z, Wang Z. Prevalence of the cardiovascular health status in adults: a systematic review and meta-analysis. Nutrition, Metabolism and Cardiovascular Diseases 2018; VIII

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Estimating the Association of the 2017 and 2014 Hypertension Guidelines With Cardiovascular Events and Deaths in US Adults

Cited by 93 publications

References 44 publications

Sex-Specific Association of Blood Pressure Categories With All-Cause Mortality: The Rural Chinese Cohort Study

Sex-Specific Association of Blood Pressure Categories With All-Cause Mortality: The Rural Chinese Cohort Study

Impact of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline on the prevalence of hypertension in young Saudi women

Cardiovascular health status and its associations with cardiovascular disease and ischemic heart disease prevalence in Australian adults

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