Key result
Applying the 2017 ACC/AHA guideline compared to the JNC7 guideline increased the standardized prevalence of hypertension in Iranian adults from 22.3% to 36.5%, reclassifying 14.1% of the population.
Why the study?
Does the application of the 2017 ACC/AHA guideline increase the estimated prevalence of hypertension compared to the JNC7 guideline in Iranian adults aged 35-70?
Cross-Sectional (n=163,770)
Yes
Does the application of the 2017 ACC/AHA guideline increase the estimated prevalence of hypertension compared to the JNC7 guideline in Iranian adults aged 35-70?
Effect estimate: 14.1% absolute increase
Absolute Event Rate: 36.5% vs 22.3%
Application of the 2017 ACC/AHA hypertension guideline in Iran increases the estimated prevalence of hypertension by 14.1% absolute compared to JNC7, primarily reclassifying young, low-risk males.
May raise hypertension prevalence estimates in Iran; leaves open outcome validation before adopting 2017 ACC/AHA thresholds.
In this cross-sectional population-based study, we used the baseline data of the Prospective Epidemiologic Research Studies in IrAN (PERSIAN) cohort study collected in Iran from 2014 to 2020. The main outcomes were the prevalence of hypertension and proportion of awareness, treatment, and control based on the 2017 ACC/AHA guideline compared to the seventh report of the Joint National Committee (JNC7). Of the total of 163770 participants, aged 35 to 70 years, 55.2% were female. The sex-age standardized prevalence of hypertension was 22.3% (95% CI: 20.6-24.1) based on the JNC7 guideline and 36.5% (31.1-41.8) based on the ACC/AHA guideline. A total of 24312 participants [14.1% [10.1, 18.1)] were newly diagnosed based on the ACC/AHA guideline. Compared to adults diagnosed with hypertension based on the JNC7 guideline, the newly diagnosed participants were mainly young literate males who had low levels of risk factors and were free from conventional comorbidities of hypertension. About 30.7% (25.9, 35.4) of them (4.3% of the entire population) were eligible for pharmacologic intervention based on the ACC/AHA guideline. Implementation of the new guideline may impose additional burden on health systems. However, early detection and management of elevated blood pressure may reduce the ultimate burden of hypertension in Iran.
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Sepanlou et al. (2021) conducted a cross-sectional in Hypertension (n=163,770). 2017 ACC/AHA hypertension guideline criteria vs. JNC7 hypertension guideline criteria was evaluated on Sex-age standardized prevalence of hypertension (14.1% absolute increase). Applying the 2017 ACC/AHA guideline compared to the JNC7 guideline increased the standardized prevalence of hypertension in Iranian adults from 22.3% to 36.5%, reclassifying 14.1% of the population.
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