Why the study?
Different definitions have been proposed to categorize hypertension, motivating an evaluation of differences in the prevalence of hypertension-associated measures under ACC/AHA criteria versus JNC7 criteria.
How does the prevalence of hypertension change when applying ACC/AHA 2017 criteria compared to JNC7 criteria in Iranian adults?
How does the prevalence of hypertension change when applying ACC/AHA 2017 criteria compared to JNC7 criteria in Iranian adults?
Applying the 2017 ACC/AHA hypertension guidelines more than doubles the prevalence of hypertension in Iranian adults compared to JNC7 criteria, significantly increasing the proportion of unaware and uncontrolled patients.
Raises hypertension prevalence estimates in Iranian adults; leaves open whether ACC/AHA thresholds improve outcomes versus JNC7.
BACKGROUND: Different definitions have been proposed to categorize hypertension. We aimed to investigate the difference in prevalence of measures associated with hypertension according to the American College of Cardiology/American Heart Association (ACC/AHA) criteria versus Joint National Committee 7 (JNC7) criteria. METHODS: We analyzed the data of 10,000 participants of Yazd Health Study (YaHS) aged 20-69 years. Blood pressure was measured three times with standard protocol defined by ACC/AHA. Prevalence of high blood pressure measure was compared in both definitions and absolute differences reported. RESULTS: The prevalence of high blood pressure in our measurement was 61.0% according to ACC/AHA, and 28.9% according to JNC 7. The prevalence of self-reported hypertension was 18.6%. Age and sex standardized prevalence rates of high blood pressure measure indicates a 2.4-fold increase in the prevalence rate (30.1% absolute difference) by the ACC/AHA guideline. While the prevalence increased in all age groups, the age group of 20-29 showed the highest relative increase by 3.6 times (10.6% vs. 38.1%). High blood pressure measure among people with diabetes increased from 45.8 to 75.3% with the ACC/AHA guideline. Of the people who had no past history of diagnosed hypertension (n = 7887), 55.1 and 22.7% had high blood pressure measure by ACC/AHA and JNC-7 guidelines, respectively. From JNC7 to ACC/AHA, the overall difference in unawareness about HTN increased by 32.4%. CONCLUSION: Prevalence of hypertension associated measures increased over two folds by using the ACC/AHA criteria compared to JNC 7. Also, change in the criteria, reduces awareness of the disease and increases uncontrolled hypertension respectively. More research is needed to determine if the new definitions can affect management of hypertension in societies. Considering local priorities and implication of cost effective may improve implementation of new definitions for hypertension in different countries.
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Mirzaei et al. (2020) studied this question.
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