Abstract P205: Potential Impact of the 2014 High Blood Pressure Guideline on Adults in China and the US
Introduction: Compared with the JNC 7 guideline, the 2014 evidence-based guideline for the management of high blood pressure (BP) relaxed the BP thresholds for initiating drug treatment and treatment goals for older adults (≥60 years) and for those with diabetes and chronic kidney disease.
Hypothesis: The aim of this study was to estimate the proportions and absolute numbers of adults who would be potentially affected by the new guideline and to compare their cardiovascular disease (CVD) risks with the total adult populations in China and the US, respectively.
Methods: Data from the China National Diabetes and Metabolic Disorders Study conducted in 2007-08 (n=40,071) and the US NHANES conducted in 2005-12 (n=9,922) were used in this analysis. Both studies were conducted in nationally representative samples using standard measurement methods.
Results: Among Chinese and US adults (≥20 years) who were eligible for treatment under JNC 7, 11.5% (95% CI, 10.4-12.6%; 32.5 million) and 5.0% (95% CI, 4.2-6.0%; 3.5 million) would not meet criteria for initiating drug treatment under 2014 guidelines, while 3.0% (95% CI, 2.3%-4.0%; 8.5 million) and 9.1% (95% CI, 8.0%-10.4%; 6.3 million) would be reclassified as meeting BP goals, respectively. Furthermore, 50.8% (95% CI, 48.5-53.1%) of US and 7.5% (95% CI, 6.7%-8.4%) of Chinese adults who were eligible for treatment under JNC 7 had met more stringent JNC 7 goals by treatment and would require less intensive or no treatment under the 2014 guideline. Compared to the total adult population and treated patients at JNC 7 goal, those who were potentially affected by the 2014 guideline had greater CVD risks in both China and the US (Table).
Conclusion: The 2014 BP guideline will affect BP control in a substantial proportion of hypertensive patients in both China and the US. More worrisome, those affected are at greater risk for CVD compared to the total adult population and hypertensive patients treated to the JNC 7 BP goal in both countries.
Author Disclosures: Q. Zhao: None. W. Yang: None. L.A. Bazzano: None. P.K. Whelton: None. C. Chen: None. J. Xiao: None. J. He: None.
- © 2015 by American Heart Association, Inc.