scholarly journals Insight into Blood Pressure Targets for Universal Coverage of Hypertension Services in Iran: The 2017 ACC/AHA versus JNC 8 Hypertension Guidelines

2020 ◽  
Author(s):  
Mahdi Mahdavi ◽  
Mahboubeh Parsaeian ◽  
Bahram Mohajer ◽  
Mitra Modirian ◽  
Naser Ahmadi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Survey Design ◽  
Age Groups ◽  
Universal Coverage ◽  
Blood Pressure Target ◽  
Lifestyle Modifications ◽  
Treatment Rate ◽  
Blood Pressure Targets ◽  
Hypertension Guidelines ◽  
And Control

Abstract Background: We assessed and compared the prevalence, awareness, treatment, and control of hypertension in Iran under two hypertension guidelines; the 2017 ACC/AHA with an aggressive blood pressure target 130/80 mm Hg and commonly used guideline JNC8 with 140/90 mm Hg. We shed light on the implications of 2017 ACC/AHA for population subgroups and high-risk individuals eligible for non-pharmacologic and pharmacologic therapies. Methods: Data were obtained from the Iran national STEPS 2016 study. Participants included 27 738 adults ≥25 years as a representative sample of Iranians. The logistic regression models with a survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension. Results: The prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2-30.6), which soared to 53.7% (52.9-54.4) by 2017 ACC/AHA. Awareness, treatment, and control were 59.2% (58.0-60.3), 80.2% (78.9-81.4), and 39.1% (37.4-40.7) based on JNC8, which dropped to 37.1% (36.2-38.0), 71.3% (69.9-72.7), and 19.6% (18.3-21.0) respectively by 2017 ACC/AHA. By new guideline, adults 25-34 years had the largest increase in prevalence (from 7.3% to 30.7%). They also had the lowest awareness and treatment rate but the highest control rate (36.5%) among age groups. Compared with JNC8, under 2017 ACC/AHA, 24%, 15%, 17%, and 11% more individuals with dyslipidaemia, high triglyceride, diabetes, and cardiovascular disease (CVD) events respectively fell into the hypertensive category. Yet, based on 2017 ACC/AHA, 68.2% of individuals falling into a hypertensive group were supposed to receive medications (versus 95.7% in JNC8). LDL cholesterol, physical activity, and one unit of Body Mass Index were found to change blood pressure by -3.56 (-4.38, -2.74), -2.04 (-2.58, -1.50), and 0.48 (0.42, 0.53) mm Hg respectively. Conclusions: Switching from JNC8 to 2017 ACC/AHA highlighted sharp increases in prevalence and drastic declines in awareness, treatment, and control in Iran. By the 2017 ACC/AHA, more young adults and those with chronic comorbidities fell into the hypertensive category, thus might benefit from earlier interventions such as lifestyle modifications. The low control rate among treated individuals calls for a critical review of hypertension services in Iran.

scholarly journals Insight into Blood Pressure Targets for Universal Coverage of Hypertension Services in Iran: The 2017 ACC/AHA versus JNC 8 Hypertension Guidelines

2020 ◽  
Author(s):  
Mahdi Mahdavi ◽  
Mahboubeh Parsaeian ◽  
Bahram Mohajer ◽  
Mitra Modirian ◽  
Naser Ahmadi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Survey Design ◽  
Age Groups ◽  
Universal Coverage ◽  
Blood Pressure Target ◽  
Lifestyle Modifications ◽  
Treatment Rate ◽  
Blood Pressure Targets ◽  
Hypertension Guidelines ◽  
And Control

Abstract Background: We assessed and compared the prevalence, awareness, treatment, and control of hypertension in Iran under two hypertension guidelines; the 2017 ACC/AHA with an aggressive blood pressure target 130/80 mm Hg and commonly used guideline JNC8 with 140/90 mm Hg. We shed light on the implications of 2017 ACC/AHA for population subgroups and high-risk individuals eligible for non-pharmacologic and pharmacologic therapies. Methods: Data were obtained from the Iran national STEPS 2016 study. Participants included 27 738 adults ≥25 years as a representative sample of Iranians. The logistic regression models with a survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension. Results: The prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2-30.6), which soared to 53.7% (52.9-54.4) by 2017 ACC/AHA. Awareness, treatment, and control were 59.2% (58.0-60.3), 80.2% (78.9-81.4), and 39.1% (37.4-40.7) based on JNC8, which dropped to 37.1% (36.2-38.0), 71.3% (69.9-72.7), and 19.6% (18.3-21.0) respectively by 2017 ACC/AHA. By new guideline, adults 25-34 years had the largest increase in prevalence (from 7.3% to 30.7%). They also had the lowest awareness and treatment rate but the highest control rate (36.5%) among age groups. Compared with JNC8, under 2017 ACC/AHA, 24%, 15%, 17%, and 11% more individuals with dyslipidaemia, high triglyceride, diabetes, and cardiovascular disease (CVD) events respectively fell into the hypertensive category. Yet, based on 2017 ACC/AHA, 68.2% of individuals falling into a hypertensive group were supposed to receive medications (versus 95.7% in JNC8). LDL cholesterol, physical activity, and one unit of Body Mass Index were found to change blood pressure by -3.56 (-4.38, -2.74), -2.04 (-2.58, -1.50), and 0.48 (0.42, 0.53) mm Hg respectively. Conclusions: Switching from JNC8 to 2017 ACC/AHA highlighted sharp increases in prevalence and drastic declines in awareness, treatment, and control in Iran. By the 2017 ACC/AHA, more young adults and those with chronic comorbidities fell into the hypertensive category, thus might benefit from earlier interventions such as lifestyle modifications. The low control rate among treated individuals calls for a critical review of hypertension services in Iran.

scholarly journals Insight into Blood Pressure Targets for Universal Coverage of Hypertension Services in Iran: The 2017 ACC/AHA versus JNC 8 Hypertension Guidelines

2019 ◽  
Author(s):  
Mahdi Mahdavi ◽  
Mahboubeh Parsaeian ◽  
Bahram Mohajer ◽  
Mitra Modirian ◽  
Naser Ahmadi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Survey Design ◽  
Age Groups ◽  
Universal Coverage ◽  
Blood Pressure Target ◽  
Lifestyle Modifications ◽  
Treatment Rate ◽  
Blood Pressure Targets ◽  
Hypertension Guidelines ◽  
And Control

Abstract Background: We assessed and compared the prevalence, awareness, treatment, and control of hypertension in Iran under two hypertension guidelines; the 2017 ACC/AHA with an aggressive blood pressure target 130/80 mm Hg and commonly used guideline JNC8 with 140/90 mm Hg. We shed light on the implications of 2017 ACC/AHA for population subgroups and high-risk individuals eligible for non-pharmacologic and pharmacologic therapies. Methods: Data were obtained from the Iran national STEPS 2016 study. Participants included 27 738 adults ≥25 years as a representative sample of Iranians. The logistic regression models with a survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension. Results: The prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2-30.6), which soared to 53.7% (52.9-54.4) by 2017 ACC/AHA. Awareness, treatment, and control were 59.2% (58.0-60.3), 80.2% (78.9-81.4), and 39.1% (37.4-40.7) based on JNC8, which dropped to 37.1% (36.2-38.0), 71.3% (69.9-72.7), and 19.6% (18.3-21.0) respectively by 2017 ACC/AHA. By new guideline, adults 25-34 years had the largest increase in prevalence (from 7.3% to 30.7%). They also had the lowest awareness and treatment rate but the highest control rate (36.5%) among age groups. Compared with JNC8, under 2017 ACC/AHA, 24%, 15%, 17%, and 11% more individuals with dyslipidaemia, high triglyceride, diabetes, and cardiovascular disease (CVD) events respectively fell into the hypertensive category. Yet, based on 2017 ACC/AHA, 68.2% of individuals falling into a hypertensive group were supposed to receive medications (versus 95.7% in JNC8). LDL cholesterol, physical activity, and one unit of Body Mass Index were found to change blood pressure by -3.56 (-4.38, -2.74), -2.04 (-2.58, -1.50), and 0.48 (0.42, 0.53) mm Hg respectively. Conclusions: Switching from JNC8 to 2017 ACC/AHA highlighted sharp increases in prevalence and drastic declines in awareness, treatment, and control in Iran. By the 2017 ACC/AHA, more young adults and those with chronic comorbidities fell into the hypertensive category, thus might benefit from earlier interventions such as lifestyle modifications. The low control rate among treated individuals calls for a critical review of hypertension services in Iran.

scholarly journals Insight into Blood Pressure Targets for Universal Coverage of Hypertension Services in Iran: The 2017 ACC/AHA versus JNC 8 Hypertension Guidelines

2020 ◽  
Author(s):  
Mahdi Mahdavi ◽  
Mahboubeh Parsaeian ◽  
Bahram Mohajer ◽  
Mitra Modirian ◽  
Naser Ahmadi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Survey Design ◽  
Age Groups ◽  
Universal Coverage ◽  
Blood Pressure Target ◽  
Lifestyle Modifications ◽  
Treatment Rate ◽  
Blood Pressure Targets ◽  
Hypertension Guidelines ◽  
And Control

Abstract Background: We assessed and compared the prevalence, awareness, treatment, and control of hypertension in Iran under two hypertension guidelines; the 2017 ACC/AHA with an aggressive blood pressure target 130/80 mm Hg and commonly used guideline JNC8 with 140/90 mm Hg. We shed light on the implications of 2017 ACC/AHA for population subgroups and high-risk individuals eligible for non-pharmacologic and pharmacologic therapies. Methods: Data were obtained from the Iran national STEPS 2016 study. Participants included 27 738 adults ≥25 years as a representative sample of Iranians. The logistic regression models with a survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension. Results: The prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2-30.6), which soared to 53.7% (52.9-54.4) by 2017 ACC/AHA. Awareness, treatment, and control were 59.2% (58.0-60.3), 80.2% (78.9-81.4), and 39.1% (37.4-40.7) based on JNC8, which dropped to 37.1% (36.2-38.0), 71.3% (69.9-72.7), and 19.6% (18.3-21.0) respectively by 2017 ACC/AHA. By new guideline, adults 25-34 years had the largest increase in prevalence (from 7.3% to 30.7%). They also had the lowest awareness and treatment rate but the highest control rate (36.5%) among age groups. Compared with JNC8, under 2017 ACC/AHA, 24%, 15%, 17%, and 11% more individuals with dyslipidaemia, high triglyceride, diabetes, and cardiovascular disease (CVD) events respectively fell into the hypertensive category. Yet, based on 2017 ACC/AHA, 68.2% of individuals falling into a hypertensive group were supposed to receive medications (versus 95.7% in JNC8). LDL cholesterol, physical activity, and one unit of Body Mass Index were found to change blood pressure by -3.56 (-4.38, -2.74), -2.04 (-2.58, -1.50), and 0.48 (0.42, 0.53) mm Hg respectively. Conclusions: Switching from JNC8 to 2017 ACC/AHA highlighted sharp increases in prevalence and drastic declines in awareness, treatment, and control in Iran. By the 2017 ACC/AHA, more young adults and those with chronic comorbidities fell into the hypertensive category, thus might benefit from earlier interventions such as lifestyle modifications. The low control rate among treated individuals calls for a critical review of hypertension services in Iran.

scholarly journals Insight into Blood Pressure Targets for Universal Coverage of Hypertension Services in Iran: The 2017 ACC/AHA versus JNC 8 Hypertension Guidelines

2019 ◽  
Author(s):  
Mahdi Mahdavi ◽  
Mahboubeh Parsaeian ◽  
Bahram Mohajer ◽  
Mitra Modirian ◽  
Naser Ahmadi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Survey Design ◽  
Age Groups ◽  
Universal Coverage ◽  
Blood Pressure Target ◽  
Lifestyle Modifications ◽  
Treatment Rate ◽  
Blood Pressure Targets ◽  
Hypertension Guidelines ◽  
And Control

Abstract Background: We assessed and compared the prevalence, awareness, treatment, and control of hypertension in Iran under two hypertension guidelines; the 2017 ACC/AHA with an aggressive blood pressure target 130/80 mm Hg and commonly used guideline JNC8 with 140/90 mm Hg. We shed light on the implications of 2017 ACC/AHA for population subgroups and high risk individuals eligible for non-pharmacologic and pharmacologic therapies. Methods: Data were obtained from the Iran national STEPS 2016 study. Participants included 27 738 adults ≥25 years as a representative sample of Iranians. The logistic regression models with a survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension. Results: The prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2-30.6), which soared to 53.7% (52.9-54.4) by 2017 ACC/AHA. Awareness, treatment, and control were 59.2% (58.0-60.3), 80.2% (78.9-81.4), and 39.1% (37.4-40.7) based on JNC8, which dropped to 37.1% (36.2-38.0), 71.3% (69.9-72.7), and 19.6% (18.3-21.0) respectively by 2017 ACC/AHA. By new guideline, adults 25-34 years had the largest increase in prevalence (from 7.3% to 30.7%). They also had the lowest awareness and treatment rate but the highest control rate (36.5%) among age groups. Compared with JNC8, under 2017 ACC/AHA, 24%, 15%, 17%, and 11% more individuals with dyslipidaemia, high triglyceride, diabetes, and cardiovascular disease (CVD) events respectively fell into the hypertensive category. Yet, based on 2017 ACC/AHA, 68.2% of individuals falling into hypertensive group were supposed to receive medications (versus 95.7% in JNC8). LDL cholesterol, physical activity, and one unit of Body Mass Index were found to change blood pressure by -3.56 (-4.38, -2.74), -2.04 (-2.58, -1.50), and 0.48 (0.42, 0.53) mm Hg respectively. Conclusions: Switching from JNC8 to 2017 ACC/AHA highlighted sharp increases in prevalence and drastic declines in awareness, treatment, and control in Iran. By the 2017 ACC/AHA, more young adults and those with chronic comorbidities fell into the hypertensive category, thus might benefit from earlier interventions such as lifestyle modifications. The low control rate among treated individuals calls for a critical review of hypertension services in Iran.

scholarly journals Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mahdi Mahdavi ◽  
Mahboubeh Parsaeian ◽  
Bahram Mohajer ◽  
Mitra Modirian ◽  
Naser Ahmadi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Universal Coverage ◽  
Blood Pressure Targets ◽  
Hypertension Guidelines ◽  
Insight Into

scholarly journals Ten-year trends of hypertension treatment and control rate in Korea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kwang-il Kim ◽  
Eunjeong Ji ◽  
Jung-yeon Choi ◽  
Sun-wook Kim ◽  
Soyeon Ahn ◽  
...  
Keyword(s):  
Age Groups ◽  
Favorable Effect ◽  
Age Group ◽  
Hypertension Treatment ◽  
Treatment Rate ◽  
Cross Sectional ◽  
The Past ◽  
Nationally Representative ◽  
Multistage Sampling ◽  
And Control

AbstractWe analyzed the Korean National Health and Nutrition Examination Survey (KNHANES) database to determine the trends of hypertension treatment and control rate in Korea over the past 10 years. In addition, we tried to investigate the effect of chronic medical conditions on hypertension management. We investigated the hypertension prevalence, awareness, treatment, and control rate from 2008 to 2017. KNHANES, which uses a stratified multistage sampling design, is a cross-sectional, nationally representative survey conducted by the Korean government. A total of 59,282 adults (≥ 20 years) were included, which was representative of the total population of around 40 million Koreans per year. The mean age was 50.7 ± 16.4 years and 42.6% were male. The prevalence of hypertension, hypercholesterolemia, diabetes mellitus, and obesity significantly increased over the 10 years. During this period, the hypertension treatment and control rate significantly improved. Hypertension treatment rate was significantly lower in the younger age group compared to the older age group, but the control rate among the treated patients was not significantly different between age groups. The treatment and control rates of hypertension were higher in patients with multimorbidity, which implies that it has a favorable effect on the treatment and control of hypertension. Hypertension treatment and control rate have improved over the past 10 years. The higher treatment and control rate in patients with multimorbidity suggest that the more aggressive surveillance might be associated with the improvement of hypertension treatment and control rate in Korea.

Abstract P125: Hypertension, Awareness, Treatment, And Control In Nepal: Results From May Measurement Month 2020 Blood Pressure Screening

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Pawan Acharya ◽  
Sweta Koirala ◽  
Pabitra Babu Soti ◽  
Sneha Sharma ◽  
Abhishek Sapkota ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Smoking Status ◽  
Blood Pressure Measurement ◽  
Age Groups ◽  
Hypertension Status ◽  
Safety Measures ◽  
Treatment Of Hypertension ◽  
Hypertension Awareness ◽  
The Mean ◽  
And Control

Background: May Measurement Month (MMM) 2020 was not officially executed globally due to the COVID-19 pandemic. But in Nepal, the MMM 2020 was conducted by following COVID-19 safety measures. Methods: We used an opportunistic screening campaign for blood pressure measurement among individuals ≥18 years in Nepal. Of the three measurements, the second and third measurements were used to estimate the mean systolic and diastolic blood pressure(BP). We defined hypertension as the systolic BP ≥ 120 or diastolic BP≥90 mmHg and or currently taking antihypertensive medicine. Results: Among the total 11,486 participants, 57%(6568/11486) were females. The mean age of the screenees was 45years(SD=17.0). The mean systolic and diastolic BP were 125.8(SD= 18.0) and 81.6(SD=10.5) respectively. About 31.3%(3592/11481) participants had hypertension. Among the hypertensive persons, 40.2%(1444/3592) were aware of their hypertension status. Among these who were aware, 79.4%(1146/1444) were taking antihypertensive medicine. However, the overall proportion of hypertensive patients taking medicine was 32.0%(1146/3592). The BP was controlled among 46% ( 527/1444) of participants who were under medication. Logistic regression analysis adjusting age, sex, body mass index(BMI), and smoking status found males, higher age groups, higher BMI, and smokers had higher odds of being hypertensive. (Figure 1) Conclusion: The results suggest a need to address the gap in awareness, diagnosis, and treatment of hypertension in Nepal. The results are limited due to the non-random participation of screenees. Figure 1. Odds ratio plot

Controversies Among the Hypertension Guidelines

2015 ◽  
Vol 29 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Toni L. Ripley ◽  
Mary Baumert
Keyword(s):  
United States ◽  
Blood Pressure ◽  
Clinical Trials ◽  
Antihypertensive Agents ◽  
The United States ◽  
Current Debate ◽  
Hypertension Management ◽  
Patient Needs ◽  
Blood Pressure Targets ◽  
Hypertension Guidelines

Hypertension affects 80 million people in the United States. It remains poorly controlled, with only 54% of diagnosed patients treated to blood pressure targets. Hypertension management is complex in part due to the volume of antihypertensive agents, variable patient needs and responses, and inconsistent design and outcomes from clinical trials. Therefore, trustworthy clinical practice guidelines have a key role in hypertension management. The United States experienced a 10-year gap in publication of hypertension guidelines, followed by multiple guideline publications in 2013. These guidelines led to more controversy than clarity, as there was discordance among them. This review summarizes the guidelines and clinical statements influencing the current debate in order to facilitate appropriate application.

EFEK HIPOTENSIF DARI ACEi DAN ARB PADA PASIEN DIABETES MELLITUS DAN HIPERTENSI DI RSUD. ABDUL WAHAB SYAHRANIE SAMARINDA

2018 ◽  
Vol 3 (2) ◽  
pp. 186
Author(s):  
Rusdiati Helmidanora ◽  
Triswanto Sentat
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Secondary Data ◽  
National Committee ◽  
Blood Pressure Target ◽  
Blood Pressure Targets ◽  
Increased Risk ◽  
New Guidelines ◽  
National Joint Committee

More than two-thirds of patients with type 2 diabetes also experience hypertension whose development coincides with hyperglycemia, where each disease has a tendency to influence the increased risk of other diseases. Sundry new guidelines, such as the National Joint Committee 8, the American Diabetes Association recommend blood pressure targets in the diabetic population of <140/90 mmHg to reduce cardiovascular risk and prevent the progression of nephropathy. This study aims to determine whether there is a difference in achieving blood pressure target < 140/90 mmHg according to Join National Committee 8 between ACEi and ARB in patients with type 2 diabetes with hypertension. This research was conducted using a retrospective at internist clinic of Abdul Wahab Syahranie hospital, by taking secondary data from the medical record from blood pressure o 49 outpatients received a single antihypertensive either drug ACEi 29 people or ARB 34 people. This study showed that the achievement of target blood pressure by <140/90 mmHg (JNC 8 guideline) between ACEi 7 (28%) and ARB 5 (20,8%) group and it can be concluded that between ACEi and ARB drugs(P=0.5) there was no differsignificantly in achievement blood pressure target on type 2 diabetes with hypertension.

VP169 Grouping Treat-to-Target Studies In Systematic Reviews

2017 ◽  
Vol 33 (S1) ◽  
pp. 227-228
Author(s):  
Marrissa Martyn-St James ◽  
Emma Hock ◽  
Ruth Wong ◽  
Matt Stevenson ◽  
Allan Wailoo
Keyword(s):  
Blood Pressure ◽  
Usual Care ◽  
Systematic Reviews ◽  
Treatment Protocol ◽  
Treat To Target ◽  
Blood Pressure Target ◽  
Treatment Protocols ◽  
Blood Pressure Targets ◽  
Antidiabetic Treatment ◽  
Study Designs

INTRODUCTION:A Health Technology Assessment (HTA) systematic review was undertaken in rheumatoid arthritis (RA) of treat-to-target (TTT) studies (n = 16) in which studies were grouped according to: TTT versus usual care, trials comparing different targets, or trials comparing different treatment protocols. To our knowledge, this was the first RA TTT review where studies were grouped in this way. We wanted to compare if our approach had been adopted in reviews of hypertension, hyperlipidemia or diabetes.METHODS:We searched MEDLINE for systematic reviews (SRs) of TTT studies in hypertension, hyperlipidaemia or diabetes.RESULTS:Eleven SRs were included; eight were in diabetes, and four were in hypertension, while none were in hyperlipidaemia. The diabetes SRs evaluated different insulin regimens (n = 3), non-insulin medications (n = 1), any antidiabetic treatment (n = 2), metformin monotherapy versus combination therapy (n = 1), and tight versus conventional glucose control (n = 1). The metformin review grouped studies by outcome whereas all other diabetes SRs grouped studies by treatment. Two hypertension SRs evaluated the effects of any treatment on two blood pressure targets, whereas one evaluated two different treatment regimen effects on the same blood pressure target. No SR in hypertension or diabetes included a mix of TTT versus usual care, and/or same treatment protocol different targets, and/or different treatment protocols same target study designs.CONCLUSIONS:In RA TTT does not refer to a single concept but a range of different approaches to the treatment of patients and the evidence reflects this. Whilst our approach to grouping RA TTT studies in a review was novel, this made it complex for us to synthesize evidence and draw general conclusions. We did not identify any TTT reviews in hypertension or diabetes including a mix of the TTT approaches we identified in RA. At present, a comparison of the strengths and limitations of our TTT review study grouping with reviews of hypertension, hyperlipidemia or diabetes cannot be made.

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