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Potential U.S. 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.

Journal of the American College of Cardiology
|November 18, 2017
PubMed

Insights

The 2017 ACC/AHA hypertension guideline significantly increases diagnosed high blood pressure prevalence in U.S. adults compared to JNC7. More adults need medication, and many on treatment still exceed blood pressure goals.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • The 2017 ACC/AHA guideline updated hypertension definitions and treatment thresholds.
  • Previous guidelines, such as JNC7, provided different criteria for hypertension management.

Purpose of the Study:

  • To compare the prevalence of hypertension and treatment recommendations between the 2017 ACC/AHA and JNC7 guidelines.
  • To assess the proportion of U.S. adults with blood pressure above treatment goals under both guidelines.

Main Methods:

  • Analysis of National Health and Nutrition Examination Survey data (2011-2014) from 9,623 U.S. adults.
  • Standardized blood pressure measurement protocols and weighted analysis for population estimates.

Main Results:

  • The 2017 ACC/AHA guideline identified a 45.6% hypertension prevalence, versus 31.9% for JNC7.
  • Antihypertensive medication was recommended for 36.2% (ACC/AHA) vs. 34.3% (JNC7).
  • 53.4% of adults on medication exceeded BP goals under ACC/AHA, compared to 39.0% under JNC7.

Conclusions:

  • The 2017 ACC/AHA guideline substantially increases hypertension prevalence.
  • It leads to a slight rise in medication recommendations and more intensive blood pressure control targets.
  • A significant portion of treated adults remain above their blood pressure goals.
Abstract

Keywords:
hypertensionprevalencetreatment

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