Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Yale New Haven Medical Center, Waterbury Hospital, Waterbury, USA.
BMC Cardiovasc Disord. 2020 Aug 14;20(1):372. doi: 10.1186/s12872-020-01657-0.
Different definitions have been proposed to categorize hypertension. We aimed to investigate the difference in prevalence of measures associated with hypertension according to the American College of Cardiology/American Heart Association (ACC/AHA) criteria versus Joint National Committee 7 (JNC7) criteria.
We analyzed the data of 10,000 participants of Yazd Health Study (YaHS) aged 20-69 years. Blood pressure was measured three times with standard protocol defined by ACC/AHA. Prevalence of high blood pressure measure was compared in both definitions and absolute differences reported.
The prevalence of high blood pressure in our measurement was 61.0% according to ACC/AHA, and 28.9% according to JNC 7. The prevalence of self-reported hypertension was 18.6%. Age and sex standardized prevalence rates of high blood pressure measure indicates a 2.4-fold increase in the prevalence rate (30.1% absolute difference) by the ACC/AHA guideline. While the prevalence increased in all age groups, the age group of 20-29 showed the highest relative increase by 3.6 times (10.6% vs. 38.1%). High blood pressure measure among people with diabetes increased from 45.8 to 75.3% with the ACC/AHA guideline. Of the people who had no past history of diagnosed hypertension (n = 7887), 55.1 and 22.7% had high blood pressure measure by ACC/AHA and JNC-7 guidelines, respectively. From JNC7 to ACC/AHA, the overall difference in unawareness about HTN increased by 32.4%.
Prevalence of hypertension associated measures increased over two folds by using the ACC/AHA criteria compared to JNC 7. Also, change in the criteria, reduces awareness of the disease and increases uncontrolled hypertension respectively. More research is needed to determine if the new definitions can affect management of hypertension in societies. Considering local priorities and implication of cost effective may improve implementation of new definitions for hypertension in different countries.
不同的定义被提出以分类高血压。我们旨在研究根据美国心脏病学会/美国心脏协会（ACC/AHA）标准与联合国家委员会 7 （JNC7）标准，与高血压相关的措施的患病率的差异。
我们分析了 Yazd 健康研究（YaHS）的 10000 名年龄在 20-69 岁的参与者的数据。血压使用 ACC/AHA 定义的标准方案测量三次。在这两种定义中比较了高血压测量的患病率，并报告了绝对差异。
根据 ACC/AHA，我们的测量中高血压的患病率为 61.0%，根据 JNC 7 为 28.9%。自我报告的高血压患病率为 18.6%。年龄和性别标准化的高血压测量患病率表明，按照 ACC/AHA 指南，患病率增加了 2.4 倍（绝对差异为 30.1%）。虽然所有年龄组的患病率都有所增加，但 20-29 岁年龄组的相对增加最高，增加了 3.6 倍（10.6%对 38.1%）。按照 ACC/AHA 指南，患有糖尿病的人高血压测量率从 45.8%增加到 75.3%。在没有既往诊断的高血压病史的人群中（n=7887），分别有 55.1%和 22.7%的人按照 ACC/AHA 和 JNC-7 指南测量出高血压。从 JNC7 到 ACC/AHA，对 HTN 不知情的总体差异增加了 32.4%。
与 JNC 7 相比，使用 ACC/AHA 标准，与高血压相关的措施的患病率增加了两倍多。此外，标准的改变，降低了对疾病的认识，并分别增加了未控制的高血压。需要进一步研究以确定新的定义是否会影响社会对高血压的管理。考虑到当地的重点和成本效益的影响，可以改善不同国家对高血压新定义的实施。
