Under 2017 BP Guidelines, CVD, Mortality Prevalence Will Likely Fall

The new 2017 hypertension guidelines—which lowered the hypertension threshold from 140/90 mm Hg to 130/80 mm Hg—will likely reduce the prevalence of major cardiovascular diseases (CVD) and all-cause mortality in US adults, according to new research.

These findings emerged from a study of 2013-2016 data from the National Health and Nutrition Examination Survey data, as well as data from antihypertensive clinical trials and population-based cohort studies.
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Using this data, researchers aimed to estimate the proportions of US adults with hypertension and those who were recommended for antihypertensive treatment based on the 2017 vs 2014 guidelines.

Reductions in CVD and all-cause mortality risks were estimated based on the assumption that the entire US adult population achieved systolic blood pressure (SBP) treatment goals in accordance with guideline recommendations.

Findings revealed that estimates of the prevalence of hypertension among US adults were significantly higher under the 2017 guidelines compared with the 2014 ones. Hypertension was estimated to affect 105.3 million (45.4%) adults in 2017 compared with 74.1 million adults (32.0%) in 2014.

The proportion of individuals recommended for antihypertensive treatment was also found to be significantly higher based on the 2017 guidelines compared with the 2014 ones (35.9% vs 31.1%).

Ultimately, the researchers found that achieving SBP treatment goals outlined in the 2017 hypertension guidelines will likely result in an estimated 610,000 fewer CVD events and 334,000 fewer total deaths among US adults aged 40 years or older, compared with an estimated 270,000 fewer CVD events and 177,000 fewer total deaths under the 2014 SBP goals.

However, the researchers noted that implementing the 2017 hypertension guidelines may increase the rates of some adverse events. Under the 2017 guidelines, hypotension and acute kidney injury or failure are estimated to increase by 62,000 and 79,000 events, respectively.

—Christina Vogt

Reference:

Bundy JD, Mills KT, Chen J, et al. Estimating the association of the 2017 and 2014 hypertension guidelines with cardiovascular events and deaths in US adults: an analysis of national data [Published online May 23, 2018]. JAMA Cardiol. doi:10.1001/jamacardio.2018.1240