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• W3007665025 abstract "Background: Arterial hypertension guidelines strongly differ between societies. The current American College of Cardiology/American Heart Association (ACC/AHA) guideline has been shown to recommend higher proportions of the general population for antihypertensive medication than the previous American and European guidelines. How cardiovascular risk differs between persons with and without an antihypertensive medication recommendation has not been examined. Additionally, the population impact of American, European, and international guidelines has not been compared systematically within the same study population.Methods: We compared the prevalence of an antihypertensive medication recommendation according to the American (Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 7 [JNC7], ACC/AHA 2017), European (European Society of Hypertension [ESH]/European Society of Cardiology [ESC] 2013/2018), and international (World Health Organization [WHO]/International Society of Hypertension [ISH] 2003) guidelines in 3092 participants of the population-based Heinz Nixdorf Recall study who received blood pressure measurements and were not taking antihypertensive medication at the baseline examination (N=3092, mean±standard deviation of age 58·1±7·5 years, 48·7% males). We furthermore compared incident cardiovascular events during the 5-year follow-up between participants with and without an antihypertensive medication recommendation.Findings: The ACC/AHA 2017 guideline recommended the highest percentage of participants for antihypertensive medication (45·8%) compared with the JNC7 (37·2%), ESH/ESC 2013 (17·8%), ESC/ESH 2018 (26·7%), or WHO/ISH 2003 (20·3%) guidelines. Participants with an antihypertensive medication recommendation had a significantly higher incidence of cardiovascular events during the 5-year follow-up compared with participants without this recommendation (2·5% vs 1·1%, p=0·003).Interpretation: Our results call for randomised controlled trials to investigate whether applying the stricter ACC/AHA 2017 recommendation for antihypertensive medication actually leads to a reduction in cardiovascular disease.Funding Statement: Heinz Nixdorf Foundation, BMBF, and DFG (projects ER 155/6-2, SI 236/8-1 and SI 236/9-1).Declaration of Interests: All authors declare no competing interests.Ethics Approval Statement: All participants gave written informed consent. The study was approved by the ethical committee of the University Duisburg-Essen, Germany." @default.
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• W3007665025 date "2019-01-01" @default.
• W3007665025 modified "2023-09-28" @default.
• W3007665025 title "How High Is Too High? Population Impact of Different Hypertension Management Guidelines" @default.
• W3007665025 doi "https://doi.org/10.2139/ssrn.3414424" @default.
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