Language
English
Publication Date
10-1-2023
Journal
American Journal of Preventive Medicine
DOI
10.1016/j.amepre.2023.04.011
PMID
37105448
PMCID
PMC10524146
PubMedCentral® Posted Date
10-1-2024
PubMedCentral® Full Text Version
Author MSS
Abstract
Introduction: The 2017 American College of Cardiology/American Heart Association blood pressure guideline redefined hypertension and lowered the blood pressure treatment target. Empirical data on the guideline's impact are needed.
Methods: Data were analyzed from Atherosclerosis Risk in Communities study participants who attended baseline pre-guideline (2016-2017) and post-guideline (2018-2019) visits with baseline systolic blood pressure between 120 and 159 mmHg. Participants were grouped according to baseline systolic blood pressure by change in classification under the new guideline as follows: not reclassified (120-129 mmHg), reclassified to Stage 1 hypertension (130-139 mmHg), and reclassified to Stage 2 hypertension (140-159 mmHg). Means and 95% CIs for systolic blood pressure changes between baseline and follow-up, changes in antihypertensive use, and percentages that achieved the post-guideline recommendation (systolic blood pressure < 130 mmHg) were calculated. Analyses were performed in 2021-2022.
Results: Among 2,193 community-dwelling Atherosclerosis Risk in Communities participants aged 71-95 years at baseline, systolic blood pressure changes between baseline and follow-up visits differed among participants not reclassified (+4.1 mmHg, 95% CI=3.0, 5.3 mmHg), reclassified to Stage 1 hypertension (-1.1 mmHg, 95% CI= -2.2, 0.1 mmHg), and reclassified to Stage 2 hypertension (-5.7 mmHg, 95% CI= -6.8, -4.7 mmHg). Antihypertensive use changed from 77.3% to 78.4% (p=0.25) among participants reclassified to Stage 1 hypertension and from 78.3% to 81.4% (p< 0.01) among participants reclassified to Stage 2 hypertension. At follow-up, 41.8% of the Stage 1 and 22.4% of the Stage 2 hypertension groups reached the systolic blood pressure < 130 mmHg goal.
Conclusions: There were small decreases in systolic blood pressure and increases in antihypertensive therapy among older adults reclassified to Stage 2 hypertension but not among those reclassified to Stage 1 hypertension by the 2017 American College of Cardiology/American Heart Association guideline.
Keywords
United States, Humans, Aged, Blood Pressure, Antihypertensive Agents, American Heart Association, Hypertension, Cardiology, Atherosclerosis, hypertension, blood pressure, guideline
Published Open-Access
yes
Recommended Citation
Wang, Michael C; Petito, Lucia C; Pool, Lindsay R; et al., "The 2017 American College of Cardiology/American Heart Association Hypertension Guideline and Blood Pressure in Older Adults" (2023). Faculty and Staff Publications. 4151.
https://digitalcommons.library.tmc.edu/baylor_docs/4151