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Potential US Population Impact of the 2017 ACC/AHA High Blood Pressure Guideline
Paul Muntner1, Robert M Carey2, Samuel Gidding3
1Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama (P.W.) pmuntner@uab.edu.
Circulation
|November 15, 2017
Summary
The 2017 ACC/AHA hypertension guideline significantly increases diagnosed high blood pressure prevalence in US adults compared to JNC7. It also recommends more medication and intensive blood pressure control for many patients.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline provides updated recommendations for hypertension management.
- These guidelines define hypertension, establish blood pressure (BP) thresholds for medication initiation, and set target BP goals.
Purpose of the Study:
- To compare the prevalence of hypertension and treatment recommendations between the 2017 ACC/AHA guideline and the JNC7 guideline.
- To assess the prevalence of uncontrolled BP among US adults under both guideline criteria.
Main Methods:
- Analysis of data from the 2011-2014 National Health and Nutrition Examination Survey (N=9,623).
- Standardized, triplicate BP measurements were averaged and weighted for US population estimates.
Main Results:
- The 2017 ACC/AHA guideline identified a higher hypertension prevalence (45.6%) compared to JNC7 (31.9%).
- Antihypertensive medication was recommended for 36.2% under ACC/AHA versus 34.3% under JNC7.
- Over half (53.4%) of US adults on medication had BP above the goal per ACC/AHA, compared to 39.0% per JNC7.
Conclusions:
- The 2017 ACC/AHA guideline leads to a substantial increase in diagnosed hypertension prevalence.
- It results in a modest rise in medication recommendations and more intensive BP control targets for treated individuals.
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