Key result
ACC/AHA hypertension criteria increase prevalence by ~25 percentage points vs Thai guidelines without expanding treatment eligibility.
Why the study?
The 2017 ACC/AHA hypertension guideline lowered the diagnostic threshold compared with the 2024 Thai guideline, potentially affecting prevalence and treatment estimates in Thailand.
Cross-Sectional (n=1,406,008)
Adopting the 2017 ACC/AHA hypertension diagnostic criteria in Thailand would more than double the number of adults diagnosed with hypertension but would not substantially increase the number of individuals requiring pharmacological therapy.
Answers are grounded in this paper and cite their sources.
Lower thresholds double hypertension diagnoses without raising treatment eligibility; leaves open effects of guideline adoption on Thai outcomes.
Background: Hypertension is a major public health challenge in Thailand. The 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline lowered the diagnostic threshold for hypertension compared with the 2024 Thai guideline, which may affect prevalence estimates and treatment requirements. Objective: To compare the prevalence of newly diagnosed hypertension and the number of individuals eligible for antihypertensive therapy under the 2017 ACC/AHA and the 2024 Thai guidelines. Methods: A descriptive analytic study was conducted using the 2022 Thai National Health Security Office data. This study included 1 406 008 adults aged 18-100 years without prior hypertension. Blood pressure levels and comorbidities were analyzed to estimate hypertension prevalence and treatment eligibility based on both guidelines. Results: Hypertension prevalence was 44.5% (95% CI, 44.4-44.5) by the 2017 ACC/AHA definition compared with 19.9% (95% CI, 19.9-20.0) by the 2024 Thai definition. Extrapolated to the Thai population, this equates to 23.6 million vs 10.6 million adults, respectively, a difference of 13.0 million cases. However, the number of individuals recommended for antihypertensive medication was nearly identical: 10.6 million (ACC/AHA) vs 10.6 million (Thai). Conclusions: Adoption of the 2017 ACC/AHA guideline would substantially increase the number of Thai adults classified as hypertensive without proportionally increasing those requiring pharmacological treatment. Broader diagnostic criteria may improve early detection and awareness but must be balanced against healthcare capacity and resource implications.
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Luangjaru et al. (2026) conducted a cross-sectional in Hypertension (n=1,406,008). 2017 ACC/AHA hypertension diagnostic criteria vs. 2024 Thai hypertension diagnostic criteria was evaluated on Hypertension prevalence (24.5 percentage point difference, 95% CI 24.4-24.6). Applying the 2017 ACC/AHA guideline increased hypertension prevalence to 44.5% compared to 19.9% under the 2024 Thai guideline, while medication eligibility remained nearly identical (20.0% vs 19.9%).
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