Key result
Application of the 2017 ACC/AHA guideline increased the prevalence of hypertension to 46.3% compared to 25.9% by the 2018 KSH guideline, with only a 1.6% increase in adults recommended for pharmacological treatment.
Why the study?
The study sought to compare the potential impacts of the 2017 ACC/AHA and 2018 KSH guidelines on hypertension prevalence, treatment recommendations, and target BP achievement in the Korean population.
Does the application of the 2017 ACC/AHA guidelines compared to the 2018 KSH guidelines change the prevalence and treatment recommendations for hypertension in Korean adults?
Cross-Sectional (n=59,767)
Does the application of the 2017 ACC/AHA guidelines compared to the 2018 KSH guidelines change the prevalence and treatment recommendations for hypertension in Korean adults?
Absolute Event Rate: 46.3% vs 25.9%
Applying the 2017 ACC/AHA guidelines to the Korean population significantly increases hypertension prevalence and uncontrolled rates, especially in younger adults, with only a marginal increase in pharmacological treatment recommendations.
ACC/AHA criteria would raise hypertension prevalence and treatment eligibility versus KSH in Koreans; leaves open optimal targets for this population.
BACKGROUND AND OBJECTIVES: This study compared the potential impacts of the 2017 American College of Cardiology/American Heart Association (ACC/AHA) and the 2018 Korean Society of Hypertension (KSH) guidelines on prevalence of hypertension, recommended antihypertensive treatment, and achievement of target blood pressure (BP) in Korean population. METHODS: We analyzed the 2007-2017 Korea National Health and Nutrition Examination Survey data to calculate guideline-specific hypertension prevalence and treatment implications on 59,767 adults aged 20 years or older by sex and age. RESULTS: The prevalence of hypertension was markedly higher 46.3% by the ACC/AHA guideline due to the lowered BP cutoff than 25.9% by the KSH guideline; the increase was most pronounced in young adults. Yet, there was only a marginal 1.6% increase in the percentage of adults suggested pharmacological approach by the ACC/AHA guideline, but selectively in the older subgroups. Overall, 45.6% of Korean adults treated for hypertension failed to meet BP goal according to the KSH guideline; the underachievement extended to 61.7% of participants according to the ACC/AHA guideline. CONCLUSIONS: The lowered BP threshold, 130/80 mmHg, by the 2017 ACC/AHA guideline, in conjuncture with 10-year risk calculation largely driven by age, would increase pharmacological treatment preferentially in very old individuals, while increasing prevalence and uncontrolled rate mostly in younger subgroups. Adoption of lower BP cutoff to the KSH guideline would require validated cardiovascular disease risk assessment tools accounting for risk distributions specific to Korean population.
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Cho et al. (2020) conducted a cross-sectional in Hypertension (n=59,767). 2017 ACC/AHA guideline criteria vs. 2018 KSH guideline criteria was evaluated on Prevalence of hypertension. Application of the 2017 ACC/AHA guideline increased the prevalence of hypertension to 46.3% compared to 25.9% by the 2018 KSH guideline, with only a 1.6% increase in adults recommended for pharmacological treatment.
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