Related Experiment Video

Updated: May 13, 2026

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
14:09

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance

Published on: March 21, 2013

20.6K

Temporal Patterns in Blood Pressure Management Before and After Recent Clinical Trials and Guideline Recommendations

Eric J Brandt1,2, Craig J Beavers3, Zhuxuan Fu4

  • 1Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.

Journal of Clinical Hypertension (Greenwich, Conn.)
|March 18, 2025
PubMed

Insights

This study examined blood pressure (BP) goal achievement and antihypertensive prescribing trends following major hypertension guideline updates. While statistically significant, the observed increase in achieving office-based systolic BP goals was small and minimally relevant.

Area of Science:

  • Cardiology
  • Clinical Practice Guidelines
  • Public Health

Background:

  • Hypertension management guidelines evolve, impacting clinical practice.
  • Assessing the real-world impact of guideline changes on patient outcomes is crucial.
  • Previous studies have not fully evaluated clinician behavior shifts in response to JNC-8, SPRINT, and the 2017 hypertension guideline.

Purpose of the Study:

  • To analyze trends in achieving blood pressure (BP) goals among older adults.
  • To evaluate changes in antihypertensive prescribing patterns.
  • To determine if clinician behavior temporally correlated with key hypertension guideline publications.

Main Methods:

  • Utilized the National Cardiovascular Data Registry (NCDR) Practice INNovation and CLinical Excellence (PINNACLE) registry.
  • Included a large cohort of patients aged over 65 years with hypertension (n=3,678,774).
  • Analyzed data from 2013 to 2018, focusing on temporal relationships with guideline releases.

Main Results:

  • A statistically significant increase in achieving office-based systolic blood pressure (SBP) was observed from 2013 to 2018.
  • The observed increase in SBP goal achievement was small and considered minimally clinically relevant.
  • Trends in antihypertensive prescribing and overall clinician behavior shifts require further detailed analysis.

Conclusions:

  • While guidelines aim to improve BP control, their real-world impact on achieving BP goals may be modest.
  • Continued monitoring of clinical practice patterns and patient outcomes is essential.
  • Further research is needed to understand the factors influencing the translation of guidelines into significant clinical improvements.

Keywords:
clinical management of high blood pressure (HBP)epidemiologyhypertension—generaloutcomes of caretreatment and diagnosis/guidelines

More Related Videos

Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness05:51

Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness

Published on: May 3, 2018

17.3K
Real-Time Monitoring and Modulation of Blood Pressure in a Rabbit Model of Ischemic Stroke09:00

Real-Time Monitoring and Modulation of Blood Pressure in a Rabbit Model of Ischemic Stroke

Published on: February 10, 2023

1.1K

Related Concept Videos

Factors affecting Blood pressure01:28

Factors affecting Blood pressure

Several physiological and lifestyle factors influence blood pressure (BP). Understanding these factors is crucial as they are significant in patient education and blood pressure management.
Physiological Factors:
Errors occurring during blood pressure monitoring01:25

Errors occurring during blood pressure monitoring

Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Special considerations while measuring blood pressure01:28

Special considerations while measuring blood pressure

When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Pre-Procedural Guidelines for Assessing Blood Pressure01:10

Pre-Procedural Guidelines for Assessing Blood Pressure

Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the patient.
Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response01:15

Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response

Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...