alexa Proportion of US adults potentially affected by the 2014 hypertension guideline.
Cardiology

Cardiology

Journal of Hypertension: Open Access

Author(s): NavarBoggan AM, Pencina MJ, Williams K, Sniderman AD, Peterson ED

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Abstract IMPORTANCE: The new 2014 blood pressure (BP) guideline released by the panel members appointed to the Eighth Joint National Committee (JNC 8; 2014 BP guideline) proposed less restrictive BP targets for adults aged 60 years or older and for those with diabetes and chronic kidney disease. OBJECTIVE: To estimate the proportion of US adults potentially affected by recent changes in recommendations for management of hypertension. DESIGN: Cross-sectional, nationally representative survey. PARTICIPANTS: Using data from the National Health and Nutrition Examination Survey between 2005 and 2010 (n = 16,372), we evaluated hypertension control and treatment recommendations for US adults. MAIN OUTCOMES AND MEASURES: Proportion of adults estimated to meet guideline-based BP targets under the 2014 BP guideline and under the previous seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guideline. RESULTS: The proportion of younger adults (18-59 years) with treatment-eligible hypertension under the JNC 7 guideline was 20.3\% (95\% CI, 19.1\%-21.4\%) and decreased to 19.2\% (95\% CI, 18.1\%-20.4\%) under the 2014 BP guideline. Larger declines were observed among older adults (≥60 years), decreasing from 68.9\% (95\% CI, 66.9\%-70.8\%) under JNC 7 to 61.2\% (95\% CI, 59.3\%-63.0\%) under the 2014 BP guideline. The proportion of adults with treatment-eligible hypertension who met BP goals increased slightly for younger adults, from 41.2\% (95\% CI, 38.1\%-44.3\%) under JNC 7 to 47.5\% (95\% CI, 44.4\%-50.6\%) under the 2014 BP guideline, and more substantially for older adults, from 40.0\% (95\% CI, 37.8\%-42.3\%) under JNC 7 to 65.8\% (95\% CI, 63.7\%-67.9\%) under the 2014 BP guideline. Overall, 1.6\% (95\% CI, 1.3\%-1.9\%) of US adults aged 18-59 years and 27.6\% (95\% CI, 25.9\%-29.3\%) of adults aged 60 years or older were receiving BP-lowering medication and meeting more stringent JNC 7 targets. These patients may be eligible for less stringent or no BP therapy with the 2014 BP guideline. CONCLUSIONS AND RELEVANCE: Compared with the JNC 7 guideline, the 2014 BP guideline from the panel members appointed to the JNC 8 was associated with a reduction in the proportion of US adults recommended for hypertension treatment and a substantial increase in the proportion of adults considered to have achieved goal BP, primarily in older adults. This article was published in JAMA and referenced in Journal of Hypertension: Open Access

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