Can hypertension guidelines be improved?

1996 ◽  
Vol 72 (1) ◽  
pp. 2-2
Keyword(s):  
Hypertension Guidelines

A Comparison of the Impact of the 2017 ACC/AHA Hypertension Guidelines on Primary Care Populations With and Without Diabetes

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 172-OR
Author(s):  
JOANN M. SPERL-HILLEN ◽  
JEFFREY P. ANDERSON ◽  
JAY R. DESAI ◽  
KAREN L. MARGOLIS ◽  
A. LAUREN CRAIN ◽  
...  
Keyword(s):  
Primary Care ◽  
Hypertension Guidelines ◽  
The Impact

scholarly journals Thoracic Aortic Calcification and Pre-Clinical Hypertension by New 2017 ACC/AHA Hypertension Guidelines

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1027
Author(s):  
Ya-Ting Jan ◽  
Pei-Shan Tsai ◽  
Chris T. Longenecker ◽  
Dao-Chen Lin ◽  
Chun-Ho Yun ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Surrogate Marker ◽  
Heart Association ◽  
Aortic Calcification ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Contributing Factors ◽  
Hypertension Guidelines ◽  
Pressure Threshold ◽  
Thoracic Aortic Calcification

The recently revised 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension (HTN) guidelines employ a lower blood pressure threshold to define HTN, aiming for earlier prevention of HTN-related cardiovascular diseases (CVD). Thoracic aortic calcification (TAC), a new surrogate marker of aging and aortic medial layer degeneration, and different stages of HTN, according to the 2017 ACC/AHA HTN guidelines, remain unknown. We classified 3022 consecutive asymptomatic individuals enrolled into four HTN categories using the revised 2017 ACC/AHA guidelines: normal blood pressure (NBP), elevated blood pressure (EBP), and stage 1 (S1) and stage 2 (S2) HTN. The coronary artery calcification score and TAC metrics (total Agaston TAC score, total plaque volume (mm3), and mean density (Hounsfield units, HU)) were measured using multi-detector computed tomography. Compared to NBP, a graded and significant increase in the TAC metrics was observed starting from EBP and S1 and S2 HTN, using the new 2017 ACC/AHA guidelines (NBP as reference; all trends: p < 0.001). These differences remained consistent after being fully adjusted. Older age (>50 years), S1 and S2 HTN, prevalent diabetes, and chronic kidney disease (<60 mL/min/1.73 m2) are all independently contributing factors to higher TAC risk using multivariate stepwise logistic regressions (all p ≤ 0.001). The optimal cutoff values of systolic blood pressure, diastolic blood pressure, and pulse pressure were 121, 74, and 45 mmHg, respectively, for the presence of TAC after excluding subjects with known CVD and ongoing HTN medication treatment. Our data showed that the presence of TAC starts at a stage of elevated blood pressure not categorized as HTN from the updated 2017 ACC/AHA hypertension guidelines.

scholarly journals Doctors’ Knowledge of Hypertension Guidelines Recommendations Reflected in Their Practice

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Nafees Ahmad ◽  
Amer Hayat Khan ◽  
Irfanullah Khan ◽  
Amjad Khan ◽  
Muhammad Atif
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Median Number ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Attitude Score ◽  
Cross Sectional ◽  
Uncomplicated Hypertension ◽  
Adequate Knowledge ◽  
Hypertension Guidelines

Aim. To evaluate doctors’ knowledge, attitude, and practices and predictors of adherence to Malaysian hypertension guidelines (CPG 2008). Methods. Twenty-six doctors involved in hypertension management at Penang General Hospital were enrolled in a cross-sectional study. Doctors’ knowledge and attitudes towards guidelines were evaluated through a self-administered questionnaire. Their practices were evaluated by noting their prescriptions written to 520 established hypertensive outpatients (20 prescriptions/doctor). SPSS 17 was used for data analysis. Results. Nineteen doctors (73.07%) had adequate knowledge of guidelines. Specialists and consultants had significantly better knowledge about guidelines’ recommendations. Doctors were positive towards guidelines with mean attitude score of 23.15±1.34 points on a 30-point scale. The median number of guidelines compliant prescriptions was 13 (range 5–20). Statistically significant correlation (rs = 0.635, P<0.001) was observed between doctors’ knowledge and practice scores. A total of 349 (67.1%) prescriptions written were guidelines compliant. In multivariate analysis hypertension clinic (OR = 0.398, P=0.008), left ventricular hypertrophy (OR = 0.091, P=0.001) and heart failure (OR = 1.923, P=0.039) were significantly associated with guidelines adherence. Conclusion. Doctors’ knowledge of guidelines is reflected in their practice. The gap between guidelines recommendations and practice was seen in the pharmacotherapy of uncomplicated hypertension and hypertension with left ventricular hypertrophy, renal disease, and diabetes mellitus.

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.

Hypertension guidelines

2015 ◽  
Vol 40 (6) ◽  
pp. 32-37
Author(s):  
Leslie Louise Davis
Keyword(s):  
Hypertension Guidelines
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