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New ACC/AHA Hypertension Guidelines Make 130 the New 140

The American College of Cardiology (ACC) and the American Heart Association (AHA) have released a new guideline on hypertension with a new definition that will call 130 to 139 mm Hg systolic or 80 to 89 mm Hg stage 1 hypertension.

Officially the 2017 "ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults," the document includes new recommendations on the definition of hypertension, systolic and diastolic blood pressure thresholds for initiation of treatment with antihypertensive medications, and an aggressive new BP treatment target.

The guidelines were released here at the American Heart Association (AHA) 2017 Scientific Sessions and published simultaneously in the Journal of the American College of Cardiology , and in the AHA journal Hypertension .

"The goal was to provide a comprehensive guideline for diagnosis, prevention, evaluation, treatment, and very important, strategies to improve control rates during treatment," Dr Paul Whelton (Tulane University School of Public Health and Tropical Medicine, New Orleans, LA), chair of the 2017 Hypertension Practice Guidelines, told a press conference here.

Whelton pointed to five main areas of emphasis in the new guideline:

  • A strong emphasis on blood-pressure measurement, both accuracy of blood-pressure measurements and using the average of measures taken over several visits, as well as an emphasis on out-of-office blood-pressure measurements, "which is relatively new for a blood-pressure guideline," he noted.
  • A new blood-pressure classification system, updating the previous Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7) guidelines. "We thought the evidence supported a slightly new classification system," he said.
  • A new approach to decision-making for treatment that incorporates underlying cardiovascular risk.
  • Lower targets for blood pressure during the management of hypertension.
  • Strategies to improve blood-pressure control during treatment with an emphasis on lifestyle approaches.

 

  1. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2017; DOI:10.1161/HYP.0000000000000066 Article
  2. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2017; DOI:10.1016/j.jacc.2017.11.005. Article
  3. Muntner P, Carey RM, Gidding S, et al. Potential US population impact of the 2017 American College of Cardiology/American Heart Association High Blood Pressure Guideline. Circulation2017; DOI:10.1161/CIRCULATIONAHA.117.032582. Article
  4.  https://www.medscape.com/viewarticle/888560