Abstract 11933: The Impact of the Eighth Joint National Committee Guidelines for the Treatment of High Blood Pressure on an Older US Cohort: The Atherosclerosis Risk in Communities Study
Introduction: The Eighth Joint National Committee (JNC 8) recently released new guidelines for the treatment of high blood pressure, recommending less aggressive treatment goals than the prior seventh Joint National Committee (JNC7) recommendations for individuals with diabetes or chronic kidney disease (CKD) as well as individuals aged ≤ 60 years. The potential impact of these changes on the older US population requires further analysis.
Methods: We performed a cross-sectional analysis of black and white participants from 4 communities in the Atherosclerosis Risk in Communities study who participated in the 5th study visit (2011-2013). Sitting blood pressure was obtained 3 times after a 5-minute rest and an average of the 3 readings was used. The use of antihypertensive medications was verified by reviewing medications brought to the visit. Blood pressure control was defined using both the previous JNC 7 goals (< 130/80 mm Hg and < 140/90 mm Hg for individuals with and without diabetes or CKD respectively) and new JNC 8 thresholds (< 140/90 mmHg for individuals with diabetes or CKD and < 150/90 mm Hg for individuals aged ≤ 60 years without diabetes or CKD).
Results: In our sample of 6,088 participants (mean age 75.6 years [range 66-90], 58.4% female, 23.2% African American), 75.0% were taking antihypertensive medications and 54.9% had either diabetes or CKD. Rates of control of hypertension according to JNC 7 and JNC 8 recommendations are shown in the table. Black individuals were less likely to have controlled blood pressure by either criterion although the increase in rates of control using JNC8 compared to JNC7 was similar between races. An analysis according to sex showed similar findings in men and women.
Conclusion: In a US cohort of older white and black individuals with a high prevalence of diabetes or CKD, approximately 1 in 6 individuals who previously would be considered to have uncontrolled blood pressure are now within goals established by the new JNC 8 guidelines.
Author Disclosures: M.D. Miedema: None. F.L. Lopez: None. M.J. Blaha: None. S.S. Virani: None. J. Coresh: None. C.M. Ballantyne: None. A.R. Folsom: None.
- © 2014 by American Heart Association, Inc.