(Press-News.org) Applying the updated 2014 blood pressure (BP) guideline to the U.S. population suggests that nearly 6 million adults are no longer classified as needing hypertension medication, and that an estimated 13.5 million adults would now be considered as having achieved goal blood pressure, primarily older adults, according to a JAMA study released online to coincide with the 2014 American College of Cardiology Scientific Sessions.
Ann Marie Navar-Boggan, M.D., Ph.D., of Duke University Medical Center, Durham, N.C., and colleagues quantified the proportion of adults potentially affected by the updated 2014 recommendations, compared to the previous guideline, issued nearly 10 years ago (Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [JNC 7]). The researchers used data from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2010 (n = 16,372), and evaluated hypertension control and treatment recommendations for U.S. adults. The new guideline proposed less restrictive BP targets for adults 60 years of age or older and for those with diabetes and chronic kidney disease.
The authors estimate that the proportion of younger adults (18-59 years) in the U.S. considered to have treatment-eligible hypertension would be decreased from 20.3 percent under JNC 7 to 19.2 percent under the 2014 BP guideline and from 68.9 percent to 61.2 percent among older adults (≥ 60 years). Extrapolating these numbers to the population represented by this NHANES sample (U.S. adults in 2007) translates to a reduction in 5.8 million adults no longer classified as needing hypertension medication (70 million under JNC 7 to 64.2 million under the 2014 BP guideline).
The proportion of adults with treatment-eligible hypertension who met BP goals also increased slightly for younger adults, from 41.2 percent under JNC 7 to 47.5 percent under the 2014 BP guideline, and more substantially for older adults, from 40.0 percent to 65.8 percent.
The authors estimate that 13.5 million adults not previously considered to be meeting BP targets would be considered at goal BP under the new guideline, with the majority affected age 60 years and older, and many of whom have diabetes, chronic kidney disease, and cardiovascular disease.
Overall, 1.6 percent of U.S. adults 18-59 years of age and 27.6 percent of adults age 60 years or older were receiving BP-lowering medication and meeting more stringent JNC 7 targets. These patients may be eligible for less stringent or no BP therapy with the 2014 BP guideline.
"Public health messaging should target the large number of adults in the United States with changing recommendations under new guideline to ensure that new recommendations do not result in unintended consequences in adults now with 'relabeled' BP status," the authors write. "Further research is needed to determine how this new guideline affects overall BP levels attained and to determine the related effects on cardiovascular disease outcomes."
(doi:10.1001/jama.2014.2531 Available pre-embargo to the media at http://media.jamanetwork.com)
Editor's Note: This research was supported in part by Duke Clinical Research Institute's research funds and unrestricted grants from M. Jean de Granpre and Louis and Sylvia Vogel. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, etc.
Editorial: The New Cholesterol and Blood Pressure Guidelines
Harlan M. Krumholz, M.D., S.M., of the Yale University School of Medicine, New Haven, Conn., writes in an accompanying editorial that these new guidelines, with their innovations and controversy, have established a new course.
"Navigating it may be uncomfortable and will perhaps force clinicians to grapple with issues that have been ignored for too long. While it is important to advocate for health and promote healthy environments and behaviors on the broader scale, for medical decision making, it is even more important to ensure informed choice with the full participation of the person who will incur the risks and benefits of the decision. When viewed through this lens, the controversies about the guidelines become less contentious and the focus shifts to refining the evidence and producing better ways to communicate what is known for decision-making purposes. By directing attention to that message, already firmly embedded in these guidelines with their bold recommendations and deference to patient preference, they may have accomplished more than they ever envisioned."
(doi:10.1001/jama.2014.2634; Available pre-embargo to the media at http://media.jamanetwork.com)
Editor's Note: Please see the article for additional information, including financial disclosures, funding and support, etc.
INFORMATION: END
Study estimates proportion of adults affected by new blood pressure guideline
2014-03-29
ELSE PRESS RELEASES FROM THIS DATE:
US, European cholesterol guidelines differ in statin use recommendations
2014-03-29
Application of U.S. and European cholesterol guidelines to a European population found that proportions of individuals eligible for statins differed substantially, with one U.S. guideline recommending statins for nearly all men and two-thirds of women, proportions exceeding those of the other guidelines, according to a JAMA study released online to coincide with the 2014 American College of Cardiology Scientific Sessions.
The common approach in cardiovascular disease (CVD) primary prevention is to identify individuals at high enough risk to justify more intensive lifestyle ...
Analysis supports use of risk equations to guide statin therapy
2014-03-29
In an analysis of almost 11,000 patients, an assessment of equations that help guide whether a patient should begin taking a statin (cholesterol lowering medication) found that observed and predicted 5-year atherosclerotic cardiovascular disease risks were similar, suggesting that these equations are helpful for clinical decision making, according to a JAMA study released online to coincide with presentation at the 2014 American College of Cardiology Scientific Sessions.
The American College of Cardiology (ACC) and the American Heart Association (AHA) recently published ...
Celiac disease linked to increased risk of coronary artery disease
2014-03-29
People with celiac disease may have a near two-fold increased risk of coronary artery disease compared with the general population, according to research to be presented at the American College of Cardiology's 63rd Annual Scientific Session.
The study is the first to look at the association between celiac disease and coronary artery disease and adds to the evolving understanding of how systemic inflammation and autoimmune processes might influence cardiovascular disease development. Data also showed a slightly higher risk of stroke among people with celiac disease compared ...
Are statins good for your love life?
2014-03-29
Statins are associated with a significant improvement in erectile function, a fact researchers hope will encourage men who need statins to reduce their risk of heart attack to take them, according to research to be presented at the American College of Cardiology's 63rd Annual Scientific Session.
Erectile dysfunction is common in older men, especially among those with cardiovascular risk factors where cholesterol-lowering statins are frequently prescribed. Previous research has suggested a negative association between statin therapy and testosterone levels, leading to ...
Study finds astronauts' hearts become more spherical in space
2014-03-29
New findings from a study of 12 astronauts show the heart becomes more spherical when exposed to long periods of microgravity in space, a change that could lead to cardiac problems, according to research to be presented at the American College of Cardiology's 63rd Annual Scientific Session.
With implications for an eventual manned mission to Mars, the findings represent an important step toward understanding how a spaceflight of 18 months or more could affect astronauts' heart health.
"The heart doesn't work as hard in space, which can cause a loss of muscle mass," ...
Daylight saving impacts the timing of heart attacks
2014-03-29
Still feeling the residual effects of springing ahead for daylight saving time? The hour of sleep lost – or gained – may play a bigger, perhaps more dangerous role in our body's natural rhythm than we think. It seems moving the clock forward or backward may alter the timing of when heart attacks occur in the week following these time changes, according to research to be presented at the American College of Cardiology's 63rd Annual Scientific Session.
Data from the largest study of its kind in the U.S. reveal a 25 percent jump in the number of heart attacks occurring the ...
Too many diet drinks may spell heart trouble for older women
2014-03-29
It appears healthy postmenopausal women who drink two or more diet drinks a day may be more likely to have a heart attack, stroke or other cardiovascular problems, according to research to be presented at the American College of Cardiology's 63rd Annual Scientific Session.
In fact, compared to women who never or only rarely consume diet drinks, those who consumed two or more a day were 30 percent more likely to suffer a cardiovascular event and 50 percent more likely to die from related disease. Researchers analyzed diet drink intake and cardiovascular risk factors from ...
New approach to leukemia testing may better define prognosis, treatment
2014-03-29
Augusta, Ga. – Nearly half of patients with the most common form of adult leukemia are said to have normal chromosomes but appear instead to have a distinct pattern of genetic abnormalities that could better define their prognosis and treatment, researchers report.
Using microarray technology that probes millions of genes within chromosomes, researchers found the unique pattern in the leukemia cells of 22 patients diagnosed with cytogenetically normal acute myelogenous leukemia, said Dr. Ravindra Kolhe, molecular pathologist at the Medical College of Georgia at Georgia ...
Commonly used intra-aortic balloon pump may have broader potential for heart patients
2014-03-29
Augusta, Ga. – The most frequently used mechanical circulatory assist device in the world may have untapped potential, physicians say.
One of many uses for the intra-aortic balloon pump is helping ensure adequate oxygen and blood delivery to a heart struggling to resume beating in the aftermath of coronary bypass surgery, said Dr. Mary Arthur, cardiovascular anesthesiologist at the Medical College of Georgia and Georgia Regents Health System.
However physicians have been advised not to use the balloon pump if heart surgery patients also have aortic insufficiency. That's ...
How Are a Skateboarding Crocodile, Breakdancing Gazelle, and Zebra DJ Teaching Kids Mindfulness?
2014-03-29
There's a new revolution quietly brewing in the entertainment industry, led by artists who seek authenticity over applause, and sincerity over spectacle. These artists are collaborating with a common goal: to create new, positive role models for kids. Confronted with technology evolving at breakneck speeds, these rebels are embracing a new movement to stop for a minute, take a breath, and slow it down.
These musicians and artists have created JUNGA WORLD, a new digital comic and animated series for kids ages 5-12, centered on six animated teenagers--and bandmates--on ...