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Re-Classifying Hypertension in the Venezuelan EVESCAM Database Using 2017 AHA/ACC Criteria: High Prevalence, Poor

Juan González-Rivas1, Jeffrey Mechanick2, Maritza Duran3

  • 1The Andes Clinic of Cardio-Metabolic Studies, Mérida, VE.

Annals of Global Health
|June 1, 2019
PubMed

Insights

The 2017 American Heart Association/American College of Cardiology guidelines significantly increased hypertension prevalence in Venezuela to 60.4%. Over 11 million adults have hypertension, with poor blood pressure control affecting millions.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • In 2017, the American Heart Association (AHA) and American College of Cardiology (ACC) revised hypertension (HTN) diagnostic criteria.
  • Previous Venezuelan hypertension prevalence data required re-analysis using the updated AHA/ACC guidelines.

Purpose of the Study:

  • To re-evaluate hypertension prevalence in Venezuela using the 2017 AHA/ACC criteria.
  • To estimate the number of Venezuelan adults with uncontrolled blood pressure (BP) under the new guidelines.

Main Methods:

  • A national, population-based, cross-sectional study (EVESCAM) surveyed 3,420 adults (July 2014-January 2017).
  • Blood pressure was measured twice using an oscillometric device.
  • Hypertension was defined by both 2017 AHA/ACC (BP ≥ 130/80 mmHg) and JNC7 (BP ≥ 140/90 mmHg) criteria.

Main Results:

  • Crude HTN prevalence was 60.4% using AHA/ACC criteria, 13% higher than JNC7.
  • Age-standardized prevalence was 55.4% in men and 49.0% in women, significantly higher than JNC7.
  • An estimated 11 million Venezuelans have HTN, with only 1.8 million controlled; 66.8% of men and 65.8% of women with self-reported HTN had uncontrolled BP.

Conclusions:

  • The 2017 AHA/ACC guidelines identify approximately half of Venezuela's adult population as hypertensive.
  • The updated criteria reveal a high burden of uncontrolled blood pressure in the Venezuelan adult population.
Abstract

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