NYMC Faculty Publications

Implications of the New 2017 American College of Cardiology/American Heart Association Guidelines for Hypertension

DOI

10.23736/S0026-4725.19.04965-X

Journal Title

Minerva Cardioangiologica

First Page

399

Last Page

410

Document Type

Article

Publication Date

October 2019

Department

Medicine

Abstract

Automated validated devices should be used for measuring blood pressure (BP). The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) hypertension guidelines recommend that a systolic BP between 120-129 mm Hg with a diastolic BP less than 80 mm Hg should be treated with lifestyle measures. These guidelines recommend treatment with lifestyle measures plus BP lowering drugs for secondary prevention of cardiovascular events in persons with clinical cardiovascular disease and an average systolic BP of >/=130 mm Hg or an average diastolic BP >/= 80 mm Hg. These guidelines recommend treatment with lifestyle measures plus BP lowering drugs for primary prevention of cardiovascular disease in persons with an estimated 10-year risk of atherosclerotic cardiovascular disease >/= 10% and an average systolic BP >/=130 mm Hg or an average diastolic BP >/=80 mm Hg. These guidelines recommend treatment with lifestyle measures plus BP lowering drugs for primary prevention of cardiovascular disease in persons with an estimated 10-year risk of atherosclerotic cardiovascular disease of /=140 mm Hg or an average diastolic BP >/= 90 mm Hg. These guidelines recommend initiating antihypertensive drug therapy with 2 first-line drugs from different classes either as separate agents or in a fixed- dose combination in persons with a BP >/=140/90 mm Hg or with a BP > 20/10 mm Hg above their blood pressure target. White coat hypertension must be excluded before starting treatment with antihypertensive drugs in persons with hypertension at low risk for atherosclerotic cardiovascular disease. Antihypertensive drug treatment for different disorders is discussed.

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