A joint AHA/ACC/CDC algorithm in the report includes the following recommendations [ 131, 137] : BP: Recommended goal of 139/89 mm Hg or less Stage 1 hypertension (systolic BP 140-159 mm Hg or diastolic BP 90-99 mm Hg): Can be treated with lifestyle modifications and, if needed, a thiazide diuretic
What are the AHA/ACC/CDC recommendations for the treatment of hypertension (high blood pressure)?
A joint AHA/ACC/CDC algorithm in the report includes the following recommendations [ 131, 137] : BP: Recommended goal of 139/89 mm Hg or less Stage 1 hypertension (systolic BP 140-159 mm Hg or diastolic BP 90-99 mm Hg): Can be treated with lifestyle modifications and, if needed, a thiazide diuretic
Which is the first comprehensive guideline for detection of high blood pressure?
S1.5-3,S1.5-4 The first comprehensive guideline for detection, evaluation, and management of high BP was published in 1977, under the sponsorship of the NHLBI.
Which antihypertensive drugs should be used to treat hypertension (high blood pressure)?
S9.2.2-21 Renin-angiotensin-aldosterone system inhibition, however, with ACE inhibitor or ARB and especially MRA would represent the preferred choice. A shared decision-making discussion, with the patient influenced by clinician judgment, should drive the ultimate choice of antihypertensive agents. 9.3.
What do the ACC and AHA guidelines mean?
Since 1980, the American College of Cardiology (ACC) and American Heart Association (AHA) have translated scientific evidence into clinical practice guidelines (guidelines) with recommendations to improve cardiovascular health.
What is the new guideline for blood pressure?
In 2017, new guidelines from the American Heart Association, the American College of Cardiology, and nine other health organizations lowered the numbers for the diagnosis of hypertension (high blood pressure) to 130/80 millimeters of mercury (mm Hg) and higher for all adults.
What is the treatment protocol for hypertension?
Treatment for hypertension should include drug classes demonstrated to reduce cardiovascular events in patients with diabetes: ACEIs, ARBs, thiazide-like diuretics, or dihydropyridine calcium channel blockers.
What is the recommended requirement for blood pressure based on the 2017 ACC AHA guidelines?
For example, the 2017 ACC/AHA CPG (2017 Hypertension CPGs) recommends a goal of <130/80 mm Hg in patients with 10-year ASCVD risk score of >10% (Class IB recommendation)1 whereas the 2019 American Diabetes Association Standards of Care recommends a target of <130/80 mm Hg in patients in whom the 10-year ASCVD risk ...
What are the new blood pressure guidelines for seniors 2021?
The new guidelines change nothing if you're younger than 60. But if you're 60 or older, the target has moved up: Your goal is to keep your blood pressure at 150/90 or lower. If you have kidney disease or diabetes, your target used to be 130/80 or lower; now it's 140/90 or lower.
What is first line of treatment for hypertension?
The strongest body of evidence indicates that for most patients with hypertension, thiazide diuretics are the best proven first-line treatment in reducing morbidity and mortality.
What is hypertension Aha?
High blood pressure (HBP or hypertension) is when your blood pressure, the force of your blood pushing against the walls of your blood vessels, is consistently too high.
What is the new blood pressure guidelines 2017?
Normal BP is defined as <120/<80 mm Hg; elevated BP 120-129/<80 mm Hg; hypertension stage 1 is 130-139 or 80-89 mm Hg, and hypertension stage 2 is ≥140 or ≥90 mm Hg.
What is the latest JNC guideline?
Patients should be treated to a target systolic pressure of less than 150 mm Hg and a target diastolic pressure of less than 90 mm Hg. Treatment does not need to be adjusted if it results in a systolic pressure lower than 140 mm Hg, as long as it is not associated with adverse effects on health or quality of life.
What is the goal blood pressure for patients with hypertension according to the ACC AHA guidelines?
Treatment Goals A target BP of less than 130/80 mm Hg is recommended for adults with confirmed hypertension and CVD or a 10-year atherosclerotic CVD risk of 10% or more. A target of less than 130/80 mm Hg may be reasonable for adults with confirmed hypertension but no additional markers of increased CVD risk.
What is high blood pressure for a 70 year old woman?
Elderly blood pressure range for men and women The American College of Cardiology (ACC) and the American Heart Association (AHA) updated their guidelines in 2017 to recommend men and women who are 65 or older aim for a blood pressure lower than 130/80 mm Hg.
Who hypertension guidelines?
The World Health Organization on Wednesday came out with a new guideline on blood pressure control suggesting that a systolic pressure of 130 should be the threshold to start medication in people with a history of heart complications or other risk factors whereas for others such a threshold would be 140/90.
What is normal BP for a 70 year old?
New Blood Pressure Standards for Seniors The ideal blood pressure for seniors is now considered 120/80 (systolic/diastolic), which is the same for younger adults.
What is the recommended blood pressure for high blood pressure?
High blood pressure should be treated earlier with lifestyle changes and in some patients with medication – at 130/80 mm Hg rather than 140/90 – based on new ACC and American Heart Association (AHA) guidelines for the detection, prevention, management and treatment of high blood pressure.
What is the normal systolic level?
Normal: Less than 120/80 mm Hg; Elevated: Systolic between 120-129 and diastolic less than 80; Stage 1: Systolic between 130-139 or diastolic between 80-89; Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg; Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication ...
Is high blood pressure a triple risk?
Additionally, the prevalence of high blood pressure is expected to triple among men under age 45, and double among women under 45, the guideline authors note. However, only a small increase is expected in the number of adults requiring antihypertensive medication.
What is the present guideline for BP?
The present guideline is intended to be a resource for the clinical and public health practice communities. It is designed to be comprehensive but succinct and practical in providing guidance for prevention, detection, evaluation, and management of high BP. It is an update of the NHLBI publication, “The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure” (JNC 7). S1.5-7 It incorporates new information from studies of office-based BP-related risk of CVD, ambulatory blood pressure monitoring (ABPM), home blood pressure monitoring (HBPM), telemedicine, and various other areas. This guideline does not address the use of BP-lowering medications for the purposes of prevention of recurrent CVD events in patients with stable ischemic heart disease (SIHD) or chronic heart failure (HF) in the absence of hypertension; these topics are the focus of other ACC/AHA guidelines. S1.5-9,S1.5-10 In developing the present guideline, the writing committee reviewed prior published guidelines, evidence reviews, and related statements. Table 3 contains a list of publications and statements deemed pertinent to this writing effort and is intended for use as a resource, thus obviating the need to repeat existing guideline recommendations.
What are practice guidelines?
Practice guidelines provide recommendations applicable to patients with or at risk of developing CVD. The focus is on medical practice in the United States, but guidelines developed in collaboration with other organizations can have a global impact. Although guidelines may be used to inform regulatory or payer decisions, they are intended to improve patients’ quality of care and align with patients’ interests. Guidelines are intended to define practices meeting the needs of patients in most, but not all, circumstances and should not replace clinical judgment.
How do payment systems improve quality of care?
With the evolution of the US health system to reward “value over volume,” payment systems have focused on financial incentives to improve quality of care. Use of performance measures promulgated by national organizations, governmental payers, and commercial payers have fostered greater attention to control of high BP among healthcare providers and their patients. These performance measures have formed the basis for determining financial incentives for pay for performance initiatives, commercial insurer “pay-for-value” contracts, and the Medicare Shared Savings Programs developed by the Centers for Medicare & Medicaid Services Innovation for Accountable Care Organizations. In addition, the Centers for Medicare and Medicaid Services has developed The Million Hearts: Cardiovascular Disease Risk Reduction Model, which is an RCT designed to identify and test scalable models of care delivery that reduce CVD risk. S12.5-5
Is BP lowering medication cost effective?
Whereas treatment of high BP with BP-lowering medications on the basis of BP level alone is considered cost effective, S8.1.2-14 use of a combination of absolute CVD risk and BP level to guide such treatment is more efficient and cost effective at reducing risk of CVD than is use of BP level alone. S8.1.2-15–S8.1.2-24 Practical approaches have been developed to translate evidence from RCTs into individual patient treatment recommendations that are based on absolute net benefit for CVD risk, S8.1.2-25 and several national and international guidelines recommend basing use of BP-lowering medications on a combination of absolute risk of CVD and level of BP instead of relying solely on level of BP. S8.1.2-26–S8.1.2-31
Do blacks have high blood pressure?
In the United States, at any decade of life, blacks have a higher prevalence of hypertension than that of Hispanic Americans, whites, Native Americans, and other subgroups defined by race and ethnicity (see Section 3.3). Hypertension control rates are lower for blacks, Hispanic Americans, and Asian Americans than for whites. S10.1-1 Among men with hypertension, non-Hispanic white (53.8%) adults had a higher prevalence of controlled high blood pressure than did non-Hispanic black (43.8%), non-Hispanic Asian (39.9%), and Hispanic (43.5%) adults. For women with hypertension, the percentage of non-Hispanic white (59.1%) adults with controlled high blood pressure was higher than among non-Hispanic black (52.3%) and non-Hispanic Asian (46.8%) adults. S10.1-1 In Hispanic Americans, the lower control rates result primarily from lack of awareness and treatment, S10.1-2,S10.1-3 whereas in blacks, awareness and treatment are at least as high as in whites, but hypertension is more severe and some agents are less effective at BP control. S10.1-4 Morbidity and mortality attributed to hypertension are also more common in blacks and Hispanic Americans than in whites. Blacks have a 1.3-times greater risk of nonfatal stroke, 1.8-times greater risk of fatal strokes, 1.5-times greater risk of HF, and 4.2-times greater risk of ESRD. S10.1-4 Hispanic Americans have lower rates of hypertension awareness and treatment than those of whites and blacks, as well as a high prevalence of comorbid CVD risk factors (eg, obesity, DM). In 2014, age-adjusted hypertension-attributable mortality rates per 1 000 persons for non-Hispanic white, non-Hispanic black, and Hispanic-American men and women were 19.3 and 15.8, 50.1 and 35.6, and 19.1 and 14.6, respectively. S10.1-5 However, Hispanics in the United States are a heterogeneous subgroup, and rates of both hypertension and its consequences vary according to whether their ancestry is from the Caribbean, Mexico, Central or South America, or Europe. S10.1-6–S10.1-8 Hispanics from Mexico and Central America have lower CVD rates than US whites, whereas those of Caribbean origin have higher rates. Thus, pooling of data for Hispanics may not accurately reflect risk in a given patient. Finally, the excess risk of CKD outcomes in at least some blacks with hypertension may be due to the presence of high-risk APOL1 (apolipoprotein L1) genetic variants. S10.1-9–S10.1-11 The rate of renal decline associated with this genotype appears to be largely unresponsive to either BP lowering or RAS inhibition. S10.1-9–S10.1-12
Is atherosclerotic disease a systemic disease?
Atherosclerotic disease in the renal arteries represents systemic disease and higher risk of both renal failure and cardiovascular morbidity and mortality. No RCT to date has demonstrated a clinical advantage of renal artery revascularization (with either angioplasty or stenting) over medical therapy. S5.4.3-2 On the basis of the CORAL (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) trial, the recommended medical approach encompasses optimal management of hypertension with an antihypertensive regimen that includes a renin-angiotensin system (RAS) blocker, in addition to low-density lipoprotein cholesterol reduction with a high-intensity statin, smoking cessation, hemoglobin A1c reduction in patients with DM, and antiplatelet therapy. S5.4.3-1
Does CPAP help with sleep apnea?
CPAP is an efficacious treatment for improving obstructive sleep apnea. However, studies of the effects of CPAP on BP have demonstrated only small effects on BP (eg, 2– to 3–mm Hg reductions), with results dependent on patient compliance with CPAP use, severity of obstructive sleep apnea, and presence of daytime sleepiness in study participants. S5.4.4-1–S5.4.4-5 Although many RCTs have been reported that address the effects of CPAP on BP in obstructive sleep apnea, most of the patients studied did not have documented hypertension, and the studies were too small and the follow-up period too short to allow for adequate evaluation. In addition, a well-designed RCT demonstrated that CPAP plus usual care, compared with usual care alone, did not prevent cardiovascular events in patients with moderate–severe obstructive sleep apnea and established CVD. S5.4.4-14
What is an appendix in a treatment plan?
In the Appendix is a template outlining a general approach for an effective treatment algorithm that incorporates the principles described previously and balances applicability to the largest number of hypertensive patients with the flexibility and the level of detail to support individualization of therapy.
When was the Heart Association Science Advisory and Coordinating Committee approved?
This document was approved by the American Heart Association Science Advisory and Coordinating Committee, the American College of Cardiology Board of Trustees, and the Centers for Disease Control and Prevention in November 2013.
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