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The new US and European guidelines in hypertension: A multi-dimensional analysis.
- Source :
-
Contemporary Clinical Trials . Jun2019, Vol. 81, p44-54. 11p. - Publication Year :
- 2019
-
Abstract
- The Systolic Blood Pressure Intervention Trial (SPRINT) compared the clinical outcomes between target systolic blood pressure (SBP) levels between 140 and 120 mmHg or lower. Both,the 2017 ACC/AHA and the 2018 ESC/ESH guidelines in hypertension are derived from the SPRINT trial and advise initiation and/or intensification of treatment at lower blood pressure thresholds. The ACC/AHA guidance supersedes the 2014 Eight Joint National Committee guideline (JNC-8) which advised initiation of treatment when the BP was 140/90 mmHg or higher; in adults 60 years or over, the target was 150/90 mmHg. Compared to JNC-8, the new guidelines lower the SBP target by 10 mmHg in patients under age of 60 years, and by 20 mmHg in the elderly. We performed a qualitative multi-dimensional analysis in order to answer two key questions: will the new guidelines deliver the stated benefits? and, will translation to the clinic be simple, risk-free, and affordable? A major investment by national healthcare administrations will be necessary for the initiation and support of this program but this decision can only be justified by a valid expectation of clinical benefit. At this time, a definitive answer is not available and a "wait and see" attitude appears appropriate and reasonable. In the interim, efforts are best directed to the immediate problem of untreated hypertension worldwide. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 15517144
- Volume :
- 81
- Database :
- Academic Search Index
- Journal :
- Contemporary Clinical Trials
- Publication Type :
- Academic Journal
- Accession number :
- 136497557
- Full Text :
- https://doi.org/10.1016/j.cct.2019.04.008