6 recent articles discussing hypertension guideline, treatment

The American College of Cardiology and the American Heart Association recently released the long-awaited hypertension guideline, which changed the definition of hypertension as systolic BP 130 mm Hg/diastolic BP 80 mm Hg. This new definition could lead to approximately 14% more American adults being diagnosed with hypertension than previously, according to the guideline authors.

Cardiology Today and Healio.com/Cardiology identified six articles regarding reaction to the hypertension guideline and new advancements and treatments for hypertension.

New hypertension guidelines lack critical guidance for managing younger patients

The recent 2017 hypertension guidelines issued by the ACC and the AHA do not provide clear direction on how to treat and manage younger hypertensive patients who are most affected by the updates, according to a commentary published in the Annals of Internal Medicine.

Although the new guidelines are extremely meticulous, they “bombarded the intended audience — clinicians on the frontline of patient care — with a mountain of information that may have spawned as many questions as it answered,” Jordana B. Cohen, MD, MSCE, and Raymond R. Townsend, MD, both from the University of Pennsylvania, wrote.

Experts: Hypertension guideline sound, but implementation challenges ahead

ANAHEIM, Calif. — Hypertension experts interviewed by Cardiology Today praised the new AHA/ACC hypertension guideline as accurately reflecting current science, but expressed concern about ease of implementation.

The guideline changed the definition of hypertension to systolic BP 130 mm Hg or higher or diastolic BP 80 mm Hg or higher, which will lead to a new diagnosis in more than 30 million U.S. adults, and recommended those thresholds be treatment targets for most adults. It also emphasizes lifestyle modification and suggests treatment decisions be based in part on the AHA/ACC’s Pooled Cohort Equation of CVD risk.

BP in older adults often declines for more than a decade before death

There is a decrease in mean systolic BP and diastolic BP for more than a decade before death among patients who died at age 60 years or older, according to a large-scale analysis of individual patient trajectories.

The data, published in JAMA Internal Medicine, showed BP decreases were present among those not treated with antihypertensive medications, but the steepest declines were among patients with hypertension, dementia, HF and late-life weight loss.

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CV health screenings rose after implementation of ACA

Screenings for certain CV risk factors, including diabetes, smoking and high BP, increased after the Affordable Care Act was implemented, according to an analysis published in The American Journal of Managed Care.

However, the researchers found men were more likely than women to use aspirin as preventive therapy.

Intensive treatment of periodontitis may reduce BP levels

ANAHEIM, Calif. — Patients with prehypertension who received intensive care for moderate to severe periodontitis had reduced systolic and diastolic BP compared with those who received standard treatment, according to data presented at the AHA Scientific Sessions.

Jun Tao, MD, PhD, chief of the department of hypertension and vascular disease and director of the Institute of Geriatrics Research at First Affiliated Hospital of Sun Yat-sen University in Guangzhou, China, told Cardiology Today. “Our present investigation is the first proof-of-concept study to demonstrate that this is the case in clinical practice.”

SPRINT: Lower BP target confers CV event reduction regardless if measurement attended

ANAHEIM, Calif. — The reduced risk for CV events associated with a lower systolic BP target in the SPRINT trial occurred regardless of whether the BP measurement was attended, according to data presented at the AHA Scientific Sessions.

The difference in mean achieved systolic BP was consistent across BP measurement techniques, with the difference in achieved BP being lower in those in the intensive group by 12.5 mm Hg in the alone for rest group, 13.1 mm Hg in the always alone group, 13.3 mm Hg in the never alone group and 14.7 mm Hg in the alone for BP measurement group.