Epidemiología de la hipertensión arterial en adultos mexicanos: diagnóstico, control y tendencias. Ensanut 2020

2021 ◽  
Vol 63 (6, Nov-Dic) ◽  
pp. 692-704
Author(s):  
Ismael Campos-Nonato ◽  
Lucía Hernández-Barrera ◽  
Cecilia Oviedo-Solís ◽  
Dolores Ramírez-Villalobos ◽  
Bernardo Hernández-Prado ◽  
...  
Keyword(s):  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Joint National Committee ◽  
National Committee

Objetivo. Describir la prevalencia de hipertensión arterial (HTA) en adultos mexicanos, la proporción que tiene tensión arterial (TA) controlada y la tendencia en el periodo 2018-2020. Material y métodos. Se midió la TA a 9 844 adultos en la Encuesta Nacional de Salud y Nutrición (Ensanut) 2020. Se consideró que tenían HTA o TA controlada cuando cumplían los criterios del Seventh Joint National Committee (JNC-7) o American Heart Association (AHA). Resultados. La prevalencia de HTA fue 49.4% (según JNC-7), de los cuales 70% desconocía su diagnóstico. Según la clasificación AHA, 30.2% de los adultos tenía HTA y 51.0% ignoraba su diagnóstico. Entre adultos con diagnóstico previo de HTA, 54.9% tuvo TA controlada. Entre el periodo 2018-2020 no se observaron cambios en las prevalencias. Conclusiones. Al menos un tercio de los adultos mexicanos tiene HTA y de ellos al menos la mitad no habían sido diagnosticados. Debe evaluarse la pertinencia de los actuales programas de diagnóstico de HTA porque el subdiagnóstico y mal control pueden ocasionar complicaciones y la muerte.

scholarly journals Factors associated with hypertension among adults in Nepal as per the Joint National Committee 7 and 2017 American College of Cardiology/American Heart Association hypertension guidelines: a cross-sectional analysis of the demographic and health survey 2016

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030206 ◽  
Author(s):  
Rajat Das Gupta ◽  
Sojib Bin Zaman ◽  
Kusum Wagle ◽  
Reese Crispen ◽  
Mohammad Rashidul Hashan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Household Wealth ◽  
Joint National Committee ◽  
National Committee ◽  
Wealth Status ◽  
Cross Sectional ◽  
Ecological Regions

ObjectivesThis study investigated the determinants of hypertension in Nepal according to both the Joint National Committee 7 (JNC7) and the American College of Cardiology/American Heart Association (2017 ACC/AHA) guidelines.DesignCross-sectional study.SettingThis study used data collected from the 2016 Nepal Demographic and Health Survey data.Participants13 393 weighted adults aged ≥18 years enrolled by a stratified cluster sampling strategy were included in our analysis.Primary and secondary outcome measuresThe primary outcome was hypertension, which was defined according to JNC7 (systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg) and 2017 ACC/AHA guidelines (SBP ≥130 mm Hg and/or DBP ≥80 mm Hg). Antihypertensive medication users were also classified as hypertensive. After descriptive analysis, multilevel logistic regression was applied to obtain ORs.ResultsAbout 21% (n=2827) and 44% (n=5918) of the individuals aged ≥18 years were classified as hypertensive according to the JNC7 and 2017 ACC/AHA guidelines, respectively. Following factors were found to be significantly associated with hypertension according to the 2017 ACC/AHA guideline: ≥70 years (adjusted OR (AOR) 5.2; 95% CI 4.3 to 6.2), 50–69 years (AOR 3.9; 95% CI 3.4 to 4.4) and 30–49 years (AOR 2.7; 95% CI 2.4 to 3.0) age groups, male gender (AOR 1.7; 95% CI 1.6 to 1.9), being overweight/obese (AOR 3.0; 95% CI 2.7 to 3.3), residence in provinces 4 (AOR 1.5; 95% CI 1.2 to 2.0) and 5 (AOR 1.5; 95% CI 1.2 to 1.9). No significant association was identified with household wealth status and ecological regions of residence using the 2017 ACC/AHA guideline.ConclusionsPer both guidelines, multiple factors were associated with hypertension. Public health programme aiming to prevent and control hypertension in Nepal should prioritise these factors and focus on individuals with a higher likelihood of hypertension irrespective of educational level, household wealth status and ecological regions of residence.

scholarly journals Comparison of the JNC7 and 2017 American College of Cardiology/American Heart Association Guidelines for the Management of Hypertension in Koreans: Analysis of Two Independent Nationwide Population-Based Studies

2019 ◽  
Vol 16 (24) ◽  
pp. 5134 ◽  
Author(s):  
Won-Jun Choi ◽  
Hye-Sun Lee ◽  
Jung Hwa Hong ◽  
Hyuk-Jae Chang ◽  
Ji-Won Lee
Keyword(s):  
Clinical Outcomes ◽  
National Health ◽  
American Heart Association ◽  
American Heart ◽  
Cox Regression ◽  
Heart Association ◽  
Survival Outcomes ◽  
National Committee ◽  
National Health Insurance System ◽  
Discrimination Ability

The optimal blood pressure (BP) guidelines in Asian populations have not been determined. We compared all-cause and cardiovascular mortality based on the Joint National Committee 7 (JNC7) and 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines. The National Health Insurance System-National Health Screening Cohort (NHIS-HEALS) and Korea National Health and Nutrition Examination Survey (KNHANES) were utilized. BPs were classified into three groups according to each guideline, and survival rates were analyzed with Kaplan-Meier curves and log-rank tests. Hazard ratios (HRs) were calculated using multivariable cox regression analyses, and the discriminatory ability for clinical outcomes was assessed by Harrell’s C-indexes. The JNC7 guidelines demonstrated a linear association between BP levels and survival outcomes. Adjusted HRs from the JNC7 guidelines differentiated the hypertension group (≥140/90) from the pre (130/80–139/89) and normal (<130 and <80) BP groups in clinical outcomes. In contrast, the 2017 ACC/AHA guidelines showed inconsistent survival outcomes according to BP classification (normal: <120 and <80, elevated: 120–129, and <80, and HTN: ≥130/80). According to Harrell’s C-indexes, the JNC7 guidelines had greater discrimination ability in survival outcomes in the NHIS-HEALS dataset. Our results suggest that the JNC7 guidelines are more appropriate than the 2017 ACC/AHA guidelines in Korean populations.

Evidenzbasierte Indikationen zur chirurgischen Therapie extrakranieller Karotisstenosen

2003 ◽  
Vol 22 (05) ◽  
pp. 222-232
Author(s):  
H.-H. Eckstein
Keyword(s):  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Amaurosis Fugax

ZusammenfassungNach Durchführung prospektiv-randomisierter Studien liegen für die Karotis-Thrombendarteriektomie (KarotisTEA) höhergradiger Karotisstenosen gesicherte Indikationen auf dem Evidenzlevel Ia mit dem Empfehlungsgrad A vor. Dies betrifft sowohl >50%ige symptomatische als auch >60%ige asymptomatische Stenosen (NASCET-Kriterien). In Subgruppen-Analysen aus NASCET konnten klinische und morphologische Variablen identifiziert werden, die auf ein besonders hohes Risiko eines karotisbedingten Schlaganfalls im natürlichen Verlauf hinweisen. Patienten mit folgenden Variablen profitieren daher besonders von der Karotis-TEA: Stenosegrad >90%, schlechter Kollateralkreislauf, kontralateraler Karotisverschluss, Plaque-Ulzerationen, Tandemstenosen, intraluminale Thromben, nicht-lakunärer Hirninfarkt, Lebensalter >75 Jahre, komplexes klinisches Risikoprofil, Hemisphären-TIA (vs. Amaurosis fugax), männliches Geschlecht. Der präventive Effekt der Karotis-TEA kann jedoch nur unter Beachtung eines niedrigen perioperativen Schlaganfallbzw. Letalitätrisikos realisiert werden. Nach Empfehlungen der American Heart Association (AHA) darf das perioperative Risiko 3% bei asymptomatischen Stenosen ohne kontralaterale Stenose, 5% bei asymptomatischen Stenosen mit hochgradiger kontralateraler Stenose oder Verschluss und 6% bei symptomatischen >50%ige Stenosen (NASCET-Kriterien) nicht überschreiten. Die Ergebnisse der Qualitätssicherung Karotis-TEA der Deutschen Gesellschaft für Gefäßchirurgie (DGG) zeigen, dass diese maximal akzeptablen Obergrenzen zum Teil deutlich unterschritten werden. Vor diesem Hintergrund stellt das Stenting von Karotisstenosen einen klinischen Heilversuch dar, der nur nach interdisziplinärem Konsil und/oder i. R. randomisierter Studien zulässig ist.

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