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Unintended consequences of the new ACC/AHA blood pressure treatment guidelines

S G Chrysant1, G S Chrysant2

  • 1University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA. schrysant@yahoo.com.

Drugs of Today (Barcelona, Spain : 1998)
|May 4, 2019
PubMed

Insights

Recent hypertension guidelines recommend strict blood pressure control, potentially impacting patients significantly. This review examines the evolution of blood pressure treatment guidelines and their implications.

Area of Science:

  • Cardiology
  • Nephrology
  • Public Health

Background:

  • Hypertension is a critical risk factor for cardiovascular disease, heart failure, chronic kidney disease, and stroke.
  • Blood pressure (BP) treatment guidelines have evolved, shifting towards stricter control, notably influenced by the SPRINT trial.
  • The latest American College of Cardiology/American Heart Association (ACC/AHA) guidelines advocate for systolic BP below 130 mmHg and diastolic BP below 80 mmHg for all individuals.

Purpose of the Study:

  • To review the current status of systolic blood pressure (SBP) control in light of recent treatment guidelines.
  • To analyze the evolution of BP treatment guidelines and their potential social and economic consequences.
  • To synthesize findings from a literature search on BP control and treatment guidelines from 2014-2018.

Main Methods:

  • Conducted a MEDLINE search of English-language literature published between 2014 and 2018.
  • Utilized keywords including 'hypertension', 'blood pressure control', 'intensive blood pressure control', 'blood pressure treatment guidelines', and 'benefits and risks of intensive blood pressure control'.
  • Retrieved 26 relevant papers for review, supplemented with collateral literature predating 2014.

Main Results:

  • Recent guidelines, such as those from the ACC/AHA, have redefined hypertension classification, moving from 'prehypertension' to 'stage 1 hypertension'.
  • The shift towards stricter BP control recommendations may have substantial social and economic implications for patient populations.
  • The review synthesizes current literature on the benefits and risks associated with intensive blood pressure control strategies.

Conclusions:

  • The evolving landscape of hypertension management necessitates a thorough understanding of current guidelines and their patient impact.
  • Further discussion is warranted regarding the benefits and risks of intensive blood pressure control in diverse patient groups.
  • The review highlights the dynamic nature of hypertension treatment recommendations and the need for ongoing evaluation.

Keywords:
Blood pressure guidelinesBlood pressure treatmentCardiovascular disordersHypertensionHypertension societies

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