Related Experiment Video
Updated: Feb 14, 2026
Measuring Blood Pressure in Mice using Volume Pressure Recording, a Tail-cuff Method
Published on: May 15, 2009
Baseline Blood Pressure, the 2017 ACC/AHA High Blood Pressure Guidelines, and Long-Term Cardiovascular Risk in SPRINT
Muthiah Vaduganathan1, Manan Pareek2, Arman Qamar1
1Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, Mass.
Insights
New hypertension guidelines identify more at-risk patients. The 2017 ACC/AHA guidelines reclassified 30.4% of SPRINT participants, showing similar cardiovascular event risks compared to older JNC 7 criteria.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Guidelines
Background:
- The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines lowered hypertension thresholds compared to previous recommendations.
- The impact of these revised guidelines on cardiovascular disease (CVD) risk in high-risk populations remains under investigation.
Purpose of the Study:
- To evaluate the prevalence and cardiovascular prognosis of patients reclassified with hypertension under the 2017 ACC/AHA guidelines compared to the JNC 7 guidelines.
- To assess the primary composite endpoint of myocardial infarction, acute coronary syndromes, stroke, heart failure, or cardiovascular death in these patient groups.
Main Methods:
- An exploratory analysis of baseline blood pressure data from the Systolic Blood Pressure Intervention Trial (SPRINT) was conducted.
- Patients were categorized based on hypertension definitions from the 2017 ACC/AHA guidelines (systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg) and JNC 7 guidelines (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg).
Main Results:
- Of 4683 patients in the SPRINT standard treatment arm, 49.7% met JNC 7 hypertension criteria, and an additional 30.4% were newly classified under the 2017 ACC/AHA guidelines.
- Over a median follow-up of 3.3 years, 319 patients experienced the primary endpoint.
- Patients newly classified with hypertension by the 2017 ACC/AHA guidelines had a similar risk of the primary endpoint (2.0 events per 100 patient-years) compared to those previously classified (2.3 events per 100 patient-years), with an adjusted hazard ratio of 1.10 (P=.48).
Conclusions:
- The 2017 ACC/AHA hypertension guidelines are expected to increase the prevalence of diagnosed hypertension, particularly in higher-risk patient cohorts.
- These revised guidelines may identify more individuals who will experience adverse cardiovascular events, necessitating closer monitoring and management.
Background:
The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines include lower thresholds to define hypertension than previous guidelines. Little is known about the impact of these guideline changes in patients with or at high risk for cardiovascular disease.
Methods:
In this exploratory analysis using baseline blood pressure assessments in Systolic Blood Pressure Intervention Trial (SPRINT), we evaluated the prevalence and associated cardiovascular prognosis of patients newly reclassified with hypertension based on the 2017 ACC/AHA (systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg) compared with the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7) guidelines (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg). The primary endpoint was the composite of myocardial infarction, other acute coronary syndromes, stroke, heart failure, or cardiovascular death.
Results:
In 4683 patients assigned to the standard treatment arm of SPRINT, 2328 (49.7%) met hypertension thresholds by JNC 7 guidelines, and another 1424 (30.4%) were newly reclassified as having hypertension based on the 2017 ACC/AHA guidelines. Over 3.3-year median follow-up, 319 patients experienced the primary endpoint (87 of whom were newly reclassified with hypertension based on the revised guidelines). Patients with hypertension based on prior guidelines compared with those newly identified with hypertension based on the new guidelines had similar risk of the primary endpoint (2.3 [95% confidence interval {CI}, 2.0-2.7] vs 2.0 [95% CI, 1.6-2.4] events per 100 patient-years; adjusted HR, 1.10 [95% CI, 0.84-1.44]; P = .48).
Conclusions:
The 2017 ACC/AHA high blood pressure guidelines are expected to significantly increase the prevalence of patients with hypertension (perhaps to a greater extent in higher-risk patient cohorts compared with the general population) and identify greater numbers of patients who will ultimately experience adverse cardiovascular events.
Related Concept Videos
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:24Blood Pressure
01:30Blood Pressure
The average BP in an adult is typically around 120/80 mmHg (millimeters of mercury). In this measurement, the numerator (120) indicates the systolic pressure, which is the pressure in the arteries during the contraction of the heart's ventricles as blood is expelled. The denominator (80) represents the...
01:17Measurement of Blood Pressure
01:28Factors affecting Blood pressure
Physiological Factors:
01:30Alterations in Blood Pressure
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...