Abstract P209: Proportion of Brazilian Adults Potentially Affected by the 2014 Hypertension Guideline (“2014 BP guideline”). Results from ELSA-Brasil.
Introduction: The new 2014 hypertension guideline released by the panel members appointed to the Eighth Joint National Committee (“2014 BP guideline”) proposed less restrictive blood pressure targets for adults older than 60 years and for those with diabetes and renal impairment.
Hypothesis: We assessed the hypothesis that the proportion of Brazilian aged 35-74 years-old potentially affected by new proposals for management of hypertension will be different according to age-strata.
Methods: We evaluated hypertension control and treatment and the proportion of participants estimated to meet guideline-based blood pressure targets under the 2014 hypertension guideline and under the previous seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guideline using data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) with 15105 participants enrolled between 2008-2010 living in six different cities.
Results: The proportion of adults (35-59 years) with treatment-eligible hypertension under the JNC 7 guideline was 31.3 % (95%Confidence Interval, 30.5%-32.1%) and decreased to 29.8 % (29.0%-30.6%) under the 2014 BP guideline. Larger declines were observed among older adults (60-74 years), decreasing from 60.6% (58.9%-62.3%) under JNC7 to 55.8% (54.1%-57.5%) under the “2014 BP guideline”. Overall, the proportion of adults with treatment-eligible hypertension who may be eligible for less stringent or no blood pressure therapy decreased 2.2% (1.9%-2.3%). This difference was more pronounced among men, 2.7% ( 2.3%-3.1%) compared to women, 1.8% (1.5%-2.5%): people aged 60-74 years-old, 4.5% (3.8%-5.2%) compared to younger participants, 1.5% (1.3%-1.7%); people with diabetes, 5.6% (4.0%-5.2%) compared to participants without diabetes, 1.4% (1.2%-1.6%); and among participants who had glomerular filtration rate fewer than 60 ml/min/1.72 m2, 11.5% (9.5%-13.5%) compared to people with normal renal function, 1.5% (1.3%-1.7%). No differences were observed according to race or previous cardiovascular diseases. Regard to control of blood pressure, the proportion of treated participants who achieved the BP targets increased slightly among participants aged 60-74 years from 53.3% (51.6%-55.0%) for the JNC-7 definition to 56.7% (55.0%-58.4%) under the 2014 BP guideline. In contrast, for people aged 35-59 years, the proportion of people under BP control was reduced from 55.5% (54.7%-56.3%) for the JNC7 definition to 53.8% (53.0%-54.6%) under the 2014 BP guideline.
Conclusion: Compared with the JNC 7 guideline, the 2014 BP guideline was associated with a reduction in the proportion of Brazilian aged 35-74 year recommended for hypertension treatment and a modest increase in the proportion of elderly considered to have achieved goal blood pressure.
Author Disclosures: P.A. Lotufo: None. P.R. Vasconcelos: None. M.S. Bittencourt: None. D. Chor: None. I.M. Bensenor: None.
- © 2015 by American Heart Association, Inc.