Increased Risk of Hypertension in Young Adults in Southwest China: Impact of the 2017 ACC/AHA High Blood Pressure Guideline

Li, Dan; Zeng, Xiaofang; Huang, Yi; Lv, Han; Li, Ge; Zhang, Nan; Huang, Wei

doi:10.1007/s11906-019-0926-y

Cited by 32 publications

(23 citation statements)

References 32 publications

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“…The increase in prevalence upon using the 2017 ACC/ AHA guideline in Iran is consistent with a similar increase in prevalence upon using this guideline in other countries e.g. Nepal [21], China [9], and the United States [24,25]. By adopting the new guideline, the largest increase in prevalence was observed among young and middle-aged individuals, which has also been reported in China [9].…”

Section: Discussionsupporting

confidence: 79%

“…Nepal [21], China [9], and the United States [24,25]. By adopting the new guideline, the largest increase in prevalence was observed among young and middle-aged individuals, which has also been reported in China [9].…”

Section: Discussionmentioning

confidence: 88%

“…This implies that targeting younger groups brings about greater benefits for hypertension UHC programs and for the society through maintaining health among the working as well as the reproductive population of the country [35]. Given this potential benefit for Iran, the use of the 2017 ACC/AHA might also benefit other middle-income countries with similar population profiles [9].…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that switching from JNC8 to the 2017 ACC/AHA increases the prevalence of hypertension [7,8]. However, evidence on the implications of the 2017 ACC/AHA guideline on the awareness, treatment, and control of hypertension is under-developed [9]. Despite the potential health benefits of the 2017 ACC/AHA guideline [7,8], adopting this guideline to enhance hypertension control in low-and middle-income countries (LMICs) is under questiongiven its economic impacts [10].…”

Section: Introductionmentioning

confidence: 99%

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Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines

et al. 2020

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Background: We compared the prevalence, awareness, treatment, and control of hypertension in Iran based on two hypertension guidelines; the 2017 ACC/AHA-with an aggressive blood pressure target of 130/80 mmHg-and the commonly used JNC8 guideline cutoff of 140/90 mmHg. We shed light on the implications of the 2017 ACC/AHA for population subgroups and high-risk individuals who were eligible for non-pharmacologic and pharmacologic therapies. Methods: Data was obtained from the Iran national STEPS 2016 study. Participants included 27,738 adults aged ≥25 years as a representative sample of Iranians. Regression models of survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension. Results: The prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2-30.6), which soared to 53.7% (52.9-54.4) based on the 2017 ACC/AHA. The percentage of awareness, treatment, and control were 59.2% (58.0-60.3), 80.2% (78.9-81.4), and 39.1% (37.4-40.7) based on JNC8, which dropped to 37.1% (36.2-38.0), 71.3% (69.9-72.7), and 19.6% (18.3-21.0), respectively, by applying the 2017 ACC/AHA. Based on the new guideline, adults aged 25-34 years had the largest increase in prevalence (from 7.3 to 30.7%). They also had the lowest awareness and treatment rate, contrary to the highest control rate (36.5%) between age groups. Compared with JNC8, based on the 2017 ACC/AHA, 24, 15, 17, and 11% more individuals with dyslipidaemia, high triglycerides, diabetes, and cardiovascular disease events, respectively, fell into the hypertensive category. Yet, based on the 2017 ACC/AHA, 68.2% of individuals falling into the hypertensive category were eligible for receiving pharmacologic therapy (versus 95.7% in JNC8). LDL cholesterol< 130 mg/dL, sufficient physical activity (Metabolic Equivalents≥600/week), and Body Mass Index were found to change blood pressure by − 3.56(− 4.38, − 2.74), − 2.04(− 2.58, − 1.50), and 0.48(0.42, 0.53) mmHg, respectively.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines

et al. 2020

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“…Here, we found the number of hypertensive patients was reached to 13,036 (42.85%) from 4,809 (15.81%) and this raise has been observed in all age group, ranging from 22.2% in 20-29 age group to 30.2% in 50-59 years old subjects. A lower increased rate has been reported in other countries; 22.4% in China (> 18 years) [16], 13.7% in the USA (> 20 years) [17], and 6-11% in Sweden (25-74 years) [15], which indicates the number of people with SBP 130-140 or DBP 80-90 was higher in Iran and this country would receive greater bene t about reducing the burden of CVD in the future by implementation of ACC/AHA guideline.…”

Section: Discussionmentioning

confidence: 61%

Impact of 2017 ACC/AHA Guideline on Prevalence, Awareness, Treatment, Control and Risk Factors of Hypertension: a Population-based, Cross-sectional Study in Iran

Sadeghi¹,

Cheraghian²,

Mohammadi³

et al. 2020

Preprint

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Background: In 2017, the American College of Cardiology/American Heart Association (ACC/AHA) provided a new guideline for hypertension prevention and management. We aimed to update the prevalence, awareness, control and risk factors of hypertension based on this guideline and to estimate the number of people who are eligible for non-pharmacologic and pharmacologic intervention. Methods: This population-based, cross-sectional study was conducted in Khuzestan, a large province in the southwest of Iran. Comprehensive information about the potential risk factors of hypertension was collected and blood pressure, blood biomarkers, and anthropometric were measured. Moreover, the dietary pattern was evaluated in 10% of the participants, using a qualitative food frequency questionnaire.Results: A total number of 30,506 individuals aged 20-65 years was included in this study. In comparison to previous guideline (JNC8), the prevalence of hypertension in Khuzestan dramatically increased by 27.04% after implementation of ACC/AHA (15.81% vs 42.85%), which was more dominant in the male population and the 50-59 age group. The sex and age adjustment of the hypertension prevalence was estimated to be 39.40%. The number of individuals required antihypertensive treatment was slightly increased from 15.53% to 21.18%; however, the level of awareness and control dramatically dropped by 23.17% & 31.78%, respectively. All hypertension-related risk factors remained significant after applying the new guideline; however, the strength of the association was reduced in the risk factors like age, waist-hip ratio, body mass index, alcohol consumption, water pipe usage, and physical activity. Similarity, the association between hypertension and history of diabetes, and cardiovascular diseases were decreased by 38%, and 62%, respectively.Conclusions: In the ACC/AHA guideline, a higher number of individuals with the pre-hypertension condition had been shifted into the hypertension category and the level of awareness, treatment, and control was dramatically fallen, which highlight a great need to expand the public health infrastructure for further managing the substantial increase in the public health burden of hypertension.

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Compound danshen dripping pills affect the pharmacokinetics of azisartan by regulating the expression of cytochrome P450 2B1, 2C6, and 2C11 in rats

Meng

Liu

Xue

et al. 2021

Journal of Pharmaceutical and Biomedical Analysis

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Increased Risk of Hypertension in Young Adults in Southwest China: Impact of the 2017 ACC/AHA High Blood Pressure Guideline

Cited by 32 publications

References 32 publications

Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines

Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines

Impact of 2017 ACC/AHA Guideline on Prevalence, Awareness, Treatment, Control and Risk Factors of Hypertension: a Population-based, Cross-sectional Study in Iran

Compound danshen dripping pills affect the pharmacokinetics of azisartan by regulating the expression of cytochrome P450 2B1, 2C6, and 2C11 in rats

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Increased Risk of Hypertension in Young Adults in Southwest China: Impact of the 2017 ACC/AHA High Blood Pressure Guideline

Cited by 32 publications

References 32 publications

Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines

Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines

Impact of 2017 ACC/AHA&nbsp;Guideline on Prevalence, Awareness, Treatment, Control and Risk Factors of Hypertension: a Population-based, Cross-sectional Study in Iran

Compound danshen dripping pills affect the pharmacokinetics of azisartan by regulating the expression of cytochrome P450 2B1, 2C6, and 2C11 in rats

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Impact of 2017 ACC/AHA Guideline on Prevalence, Awareness, Treatment, Control and Risk Factors of Hypertension: a Population-based, Cross-sectional Study in Iran