Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, and Tulane University Translational Science Institute, Tulane University, 1440 Canal Street, New Orleans, LA, 70112, USA.
Curr Hypertens Rep. 2019 Aug 31;21(10):76. doi: 10.1007/s11906-019-0980-5.
To review the recommendations of the 2017 American College of Cardiology/American Heart Association hypertension guideline and to compare it with previous guidelines on potential cardiovascular disease (CVD) and mortality risk reductions.
Compared with previous guidelines, the 2017 hypertension guideline increased the prevalence of hypertension and the number of adults recommended for antihypertensive therapy in the US population. Based on data from recent analyses, the new guideline effectively directs antihypertensive therapy toward individuals at higher CVD risk. Two recent analyses using US national data estimated that implementation of the 2017 hypertension guideline could further reduce hundreds of thousands of CVD events and deaths compared with previous guidelines. However, the new guideline might increase the number of adverse events. The new guideline also improves the number of individuals needed to treat to prevent CVD events and deaths, suggesting implementation is cost-effective. Implementation of the 2017 hypertension guideline is projected to substantially reduce CVD events and deaths in the USA but might increase the number of adverse events. Future research is needed to implement and scale up effective, equitable, and sustainable strategies for applying the new guideline in daily clinical practice.
回顾 2017 年美国心脏病学会/美国心脏协会高血压指南的建议，并将其与既往指南在潜在心血管疾病（CVD）和死亡率降低方面进行比较。
与既往指南相比，2017 年高血压指南增加了美国人群高血压的患病率和推荐接受降压治疗的成年人数量。基于近期分析的数据，新指南有效地将降压治疗指向 CVD 风险较高的个体。两项使用美国全国数据的最新分析估计，与既往指南相比，实施 2017 年高血压指南可能进一步减少数十万例 CVD 事件和死亡。然而，新指南可能会增加不良事件的数量。新指南还改善了预防 CVD 事件和死亡所需的人数，提示实施是具有成本效益的。预计实施 2017 年高血压指南将大幅降低美国的 CVD 事件和死亡，但可能会增加不良事件的数量。未来需要开展研究，实施并扩大有效的、公平的和可持续的策略，以将新指南应用于日常临床实践。
