Article Document Academic Article Information Content Entity Journal Article Continuant Continuant Entity Entity Generically Dependent Continuant 2025-06-25T02:52:31 RDF description of Impact of the 2017 American Heart Association and American College of Cardiology hypertension guideline in aged individuals - http://repository.healthpartners.com/individual/document-rn23756 Aging and Geriatrics 38 Practice Guidelines 2022-02-21T22:48:57.408-06:00 12 Impact of the 2017 American Heart Association and American College of Cardiology hypertension guideline in aged individuals Cardiovascular Diseases 17937 Drugs and Drug Therapy 10.1097/hjh.0000000000002582 public Heart Diseases 30234 document-rn23756 <p>OBJECTIVES: The AHA/ACC-2017 hypertension guideline recommends an age-independent target blood pressure (BP) of less than 130/80 mmHg. In an elderly cohort without established cardiovascular disease (CVD) at baseline, we determined the impact of this guideline on the prevalence of hypertension and associated CVD risk. METHODS: Nineteen thousand, one hundred and fourteen participants aged at least 65 years from the ASPirin in Reducing Events in the Elderly (ASPREE) study were grouped by baseline BP: 'pre-2017 hypertensive' (BP �140/90 mmHg and/or on antihypertensive drugs); 'reclassified hypertensive' (normotensive by pre-2017 guidelines; hypertensive by AHA/ACC-2017 guideline), and 'normotensive' (BP <130 and <80 mmHg). For each group, we evaluated CVD risk factors, predicted 10-year CVD risk using the Atherosclerotic Cardiovascular Disease (ASCVD) risk equation, and reported observed CVD event rates during a median 4.7-year follow-up. RESULTS: Overall, 74.4% (14�213/19�114) were 'pre-2017 hypertensive'; an additional 12.3% (2354/19�114) were 'reclassified hypertensive' by the AHA/ACC-2017 guideline. Of those 'reclassified hypertensive', the majority (94.5%) met criteria for antihypertensive treatment although 29% had no other traditional CVD risk factors other than age. Further, a relatively lower mean 10-year predicted CVD risk (18% versus 26%, P�<�0.001) and lower CVD rates (8.9 versus 12.1/1000 person-years, P�=�0.01) were observed in 'reclassified hypertensive' compared with 'pre-2017 hypertensive'. Compared with 'normotensive', a hazard ratio (95% confidence interval) for CVD events of 1.60 (1.26-2.02) for 'pre-2017 hypertensive' and 1.26 (0.93-1.71) for 'reclassified hypertensive' was observed. CONCLUSION: Applying current CVD risk calculators in the elderly 'reclassified hypertensive', as a result of shifting the BP threshold lower, increases eligibility for antihypertensive treatment but documented CVD rates remain lower than hypertensive patients defined by pre2017 BP thresholds.<p> Journal of Hypertension