Key result
2017 ACC/AHA guideline more than doubles hypertension prevalence to ~17% in reproductive-aged women vs. JNC7.
Why the study?
The impact of the 2017 ACC/AHA hypertension guideline on prevalence and treatment recommendations among U.S. reproductive-aged women compared to the JNC7 guideline was unclear.
Does the 2017 ACC/AHA guideline increase the prevalence of hypertension and medication recommendations compared to the JNC7 guideline in US reproductive-aged women?
Cross-Sectional (n=4,575)
Does the 2017 ACC/AHA guideline increase the prevalence of hypertension and medication recommendations compared to the JNC7 guideline in US reproductive-aged women?
Absolute Event Rate: 16.5% vs 7.8%
The 2017 ACC/AHA guideline more than doubles the prevalence of hypertension among US reproductive-aged women compared to JNC7, but does not significantly increase the proportion recommended for antihypertensive medication.
More than doubles hypertension prevalence labeling in reproductive-aged women without expanding medication eligibility; leaves open effects on outcomes and resource use.
OBJECTIVE: To estimate the prevalence of hypertension and antihypertensive medication recommended among U.S. reproductive-aged women according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline as compared with the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7) guideline and to identify factors associated with newly classified hypertensive women. METHODS: We analyzed data from the National Health and Nutrition Examination Survey 2005-2014. Hypertension was defined using blood pressure measurements and/or self-reported antihypertensive medication use. Multivariable Poisson regression models with robust error variance were conducted. RESULTS: Among 4,575 (weighted n = 40,194,602) non-pregnant women aged 20-44 years, the prevalence of hypertension was 16.5% using the 2017 guideline, and 7.8% based on the JNC7 guideline. Following the 2017 guideline, 8.6% would be recommended for antihypertensive medication, similar to 8.5% according to JNC7 guideline. Following the 2017 guideline, women with older age (35-44 years), obesity, and diabetes were more likely, while Hispanic women were less likely, to be newly classified as hypertensive. CONCLUSION: Among reproductive-aged women, compared to JNC7 guidelines, the prevalence of hypertension increased by 112% following the 2017 guideline, but the percentage of women recommended for antihypertensive medication was similar.
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Chen et al. (2019) conducted a cross-sectional in Hypertension (n=4,575). 2017 ACC/AHA high blood pressure guideline vs. JNC7 guideline was evaluated on Prevalence of hypertension. The 2017 ACC/AHA guideline increased the prevalence of hypertension among U.S. reproductive-aged women to 16.5% compared to 7.8% under JNC7, while medication recommendations remained similar.
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