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New BP guidelines reduce antihypertensive therapy eligibility by 6 million patients
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SAN DIEGO — The number of patients in the US who would be eligible for antihypertensive therapy decreases by 6.1 million under the guidelines written by the panel convened for the Eighth Joint National Committee, according to data presented at the American College of Cardiology Scientific Sessions.
“The new guidelines ... have been liberalized, especially for an elderly population," Vratika Agarwal, MBBS, of the department of epidemiology and biostatistics at University of California, San Francisco, told Cardiology Today. "And now, for diabetes and chronic kidney disease [CKD], the cutoff [for treatment] has been standardized, so the number of people who would require antihypertensive therapy would significantly go down. This has a significant impact on medical care."
The study included participants in the 2011-2012 NHANES survey who were aged 18 years or older and not on any antihypertensive medications. This population represented 171.4 million Americans, who had a mean age of 41.9 ± 0.8 years. Approximately half of participants were women.
The researchers found that, in comparison to the JNC 7 panel's guidelines, the JNC 8 panel's guidelines would reduce the number of patients eligible for antihypertensive medications from 21.5 million (12.5% of the population) to 15.4 million (9%). This decrease was primarily due to elderly patients specifically, with a decline in eligible patients from 8.2 million (31% of the population) under JNC-7 to 4.9 million (18.4%) under the JNC 8 panel's guidelines. Eligibility among patients with diabetes and CKD would also decrease, from 3.2 million to 1.5 million.
"The school of thought on these new guidelines is actually very varied," Agarwal said. "There are some people who don't like the guidelines and say that [they] have been liberalized too much, and that CV and stroke outcomes might actually go up. But if you speak to a nephrologist, they tend to like the guidelines because they are liberalizing for an elderly population that we were tending to overtreat." She added that recent research has suggested that the cost of treatment would decrease significantly as a result of the new guidelines compared with the JNC 7 panel's guidelines, but that the actual impact of the changes will be made apparent within the coming 2 to 3 years. – by Adam Taliercio
Reference:
Agarwal V, et al. Poster 1108-125. Presented at: American College of Cardiology Scientific Sessions: March 14-16, 2015; San Diego.
Disclosure: The researchers report no relevant financial disclosures.