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Implications of new hypertension guidelines in the United States

Monica L Bertoia1, Molly E Waring, Priya S Gupta

  • 1Department of Epidemiology, Warren Alpert Medical School of Brown University, Providence, RI, USA. mbertoia@hsph.harvard.edu

Hypertension (Dallas, Tex. : 1979)
|August 8, 2012
PubMed

Insights

Millions of Americans have uncontrolled high blood pressure (hypertension), particularly those at high risk for heart disease. Current guidelines vary, highlighting a need for improved hypertension treatment strategies.

Area of Science:

  • Cardiology
  • Public Health
  • Hypertension Management

Background:

  • The American Heart Association (AHA) issued hypertension treatment guidelines in 2007 recommending aggressive blood pressure (BP) control (<130/80 mm Hg) for high-risk individuals.
  • The 2011 American College of Cardiology Foundation/AHA guidelines suggested a less aggressive BP target (<145/90 mm Hg) for individuals over 80 years old.

Purpose of the Study:

  • To estimate the prevalence of uncontrolled BP in adults at increased risk for coronary artery disease (CAD) using both 2007 AHA and 2011 ACCF/AHA hypertension guidelines.
  • To compare the estimated burden of hypertension under different guideline recommendations.

Main Methods:

  • Cross-sectional analysis of 10,198 adult participants (aged 18-85 years) from the National Health and Nutrition Examination Survey (NHANES) 2005-2008.
  • BP data was analyzed using the 2011 ACCF/AHA guidelines (hypertension defined as BP ≥140/90 mm Hg) and the 2007 AHA guidelines.

Main Results:

  • Using the 2011 ACCF/AHA guidelines, 72 million Americans (35%) had hypertension.
  • Applying the 2007 AHA guidelines identified an additional 7 million adults (5%) with elevated BP requiring treatment, totaling 79 million (40%).
  • Individuals at high CAD risk were more likely to be aware of and treated for hypertension but less likely to achieve BP control.

Conclusions:

  • A significant portion of the American adult population, especially those at high risk for CAD, has uncontrolled hypertension.
  • Discrepancies between guideline recommendations impact the estimated burden of hypertension.
  • Enhanced strategies are necessary for effective BP management, particularly in high-risk populations.

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