Blood Pressure Control and Cardiovascular Outcomes: Real-world Implications of the 2017 ACC/AHA Hypertension...

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• The 2017 ACC/AHA hypertension guideline lowered the definition and treatment targets to 130/80 mmHg.
• Previous guidelines, like JNC8, used a higher threshold of 140/90 mmHg.
• Understanding the impact of the new guideline on hypertension prevalence and cardiovascular outcomes is crucial.

Purpose of the Study:

• To compare the hypertension prevalence and cardiovascular outcomes between the 2017 ACC/AHA and JNC8 guidelines in the Korean population.
• To evaluate the association between blood pressure control and major adverse cardiovascular events (MACEs) under the new guideline.

Main Methods:

• Cross-sectional analysis of 15,784 adults from the Korean National Health and Nutrition Examination Survey.
• Longitudinal analysis of 373,800 hypertensive adults from the Korea National Health Insurance Service cohort with an 11.0-year follow-up.
• Comparison of hypertension prevalence and MACEs risk based on 2017 ACC/AHA and JNC8 criteria.

Main Results:

• The 2017 ACC/AHA guideline identified a hypertension prevalence of 49.2%, significantly higher than the 30.4% under JNC8.
• Adults meeting the 2017 ACC/AHA BP goal showed a 21% reduced risk of MACEs compared to those meeting only JNC8 goals.
• The aggressive BP control strategy associated with the 2017 ACC/AHA guideline demonstrated improved cardiovascular outcomes.

Conclusions:

• The 2017 ACC/AHA guideline substantially increases the diagnosed prevalence of hypertension.
• Adopting the more aggressive blood pressure targets of the 2017 ACC/AHA guideline is associated with better cardiovascular outcomes.
• This study supports the implementation of the 2017 ACC/AHA guideline for improved cardiovascular care in Korea.