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Cambios en los umbrales: Cambios en la elegibilidad para el tratamiento antihipertensivo según las directrices de
Faith E Metlock1, Bede N Nriagu1, Britton Scheuermann2
1Inova Schar Heart and Vascular, Inova Health System, Falls Church, USA.
JACC. Advances
|January 22, 2026
Resumen
Las directrices de hipertensión de 2025 muestran un cambio mínimo en la elegibilidad para el tratamiento, afectando a unos 400.000 adultos. Este estudio analizó el impacto de las nuevas directrices en la terapia antihipertensiva para adultos estadounidenses.
Área de la Ciencia:
- Medicina Cardiovascular
- Salud Pública
- Directrices Clínicas
Sus antecedentes:
- La hipertensión afecta a casi la mitad de los adultos estadounidenses, lo que requiere directrices de tratamiento actualizadas.
- La directriz ACC/AHA de 2025 introduce las ecuaciones de riesgo PREVENT y las recomendaciones revisadas de tratamiento para la hipertensión en estadio 1.
- Estos cambios pueden alterar la elegibilidad para la terapia antihipertensiva.
Objetivo del estudio:
- Cuantificar los cambios en la elegibilidad para el tratamiento antihipertensivo entre las directrices de 2025 y 2017.
- Caracterizar a los adultos recién elegibles y evaluar la concordancia de la elegibilidad.
- Evaluar la solidez de los hallazgos en diferentes variantes del modelo PREVENT.
Principales métodos:
- Análisis basado en simulación utilizando datos de la Encuesta Nacional de Examen de Salud y Nutrición (2017-2020) para adultos de 30 a 79 años.
- La elegibilidad del tratamiento se determinó utilizando los criterios de las directrices de 2017 y 2025.
- Los análisis incorporaron múltiples variantes de la ecuación de riesgo PREVENT y modelado multivariable.
Principales resultados:
- Se observó un aumento neto mínimo del 0,7 % (aproximadamente 400.000 adultos) en la elegibilidad para el tratamiento según las directrices de 2025.
- La mayoría de los adultos permanecieron consistentemente inelegibles (63,3 %) o elegibles (36,3 %).
- Las personas recién elegibles fueron típicamente mujeres mayores con un IMC más alto y medidas glucémicas límite.
Conclusiones:
- La adopción de la directriz ACC/AHA de 2025 da como resultado una expansión mínima de la elegibilidad para el tratamiento antihipertensivo.
- Los hallazgos fueron consistentes en varios modelos PREVENT, lo que respalda la implementación basada en el riesgo.
- El estudio apoya la adopción de estrategias basadas en el riesgo para la implementación de directrices.
Palabras clave:
ecuaciones PREVENTterapia antihipertensivadirectrices de presión arterialriesgo de enfermedad cardiovascularhipertensiónMás Videos Relacionados
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