Key result
Application of the 2017 ACC/AHA guidelines increased the estimated prevalence of hypertension in India to 43.0%, compared to 18.5% under the old guidelines.
Why the study?
The regional impact of the updated 2017 ACC/AHA hypertension guidelines on the prevalence of hypertension in India was unknown.
Does the application of the 2017 ACC/AHA guidelines increase the estimated prevalence of hypertension in India compared to old guidelines?
Cross-Sectional (n=679,712)
Yes
Does the application of the 2017 ACC/AHA guidelines increase the estimated prevalence of hypertension in India compared to old guidelines?
Absolute Event Rate: 43% vs 18.5%
Application of the 2017 ACC/AHA hypertension guidelines more than doubles the estimated prevalence of hypertension in India compared to previous guidelines.
Raises estimated hypertension burden in India; leaves open whether new thresholds warrant expanded screening or treatment pending outcome studies.
INTRODUCTION: In 2017, the American College of Cardiology/American Heart Association revised guidelines for diagnosis and management of hypertension in adults. The regional impact of the updated guidelines on the prevalence of hypertension in India is unknown. METHODS: Data from nationally representative Indian households were analyzed to estimate the regional prevalence of hypertension according to the old and the new guidelines in men (age 18-54 years) and women (age 18-49 years). The old guidelines defined hypertension as a systolic blood pressure of ≥140 mmHg or diastolic blood pressure of ≥90 mmHg or treatment. The new guidelines define hypertension as a systolic blood pressure of ≥130 mmHg or diastolic blood pressure of ≥80 mmHg or treatment. We calculated the increase in the prevalence of hypertension among the states and union territories of India (hereafter "states"). RESULTS: Among 679,712 participants (85.6% women), the median age was 31 years (interquartile range 24, 40) and was comparable among men and women (33 vs. 31 years, respectively). The overall weighted prevalence according to old and new guidelines was 18.5% (95% CI 18.2, 18.7) and 43.0% (95% CI 42.8, 43.3), respectively. There was a significant increase in hypertension prevalence, both among men and women, and across all regions. The northeast region of the country had the highest prevalence. CONCLUSION: The overall prevalence of hypertension significantly increases with the new compared to the old guidelines, however, the regional heterogeneity of prevalence of hypertension is maintained.
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Gupta et al. (2021) conducted a cross-sectional in Hypertension (n=679,712). 2017 ACC/AHA hypertension guidelines (new guidelines) vs. Old guidelines (SBP ≥140 mmHg or DBP ≥90 mmHg or treatment) was evaluated on Prevalence of hypertension. Application of the 2017 ACC/AHA guidelines increased the estimated prevalence of hypertension in India to 43.0%, compared to 18.5% under the old guidelines.
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