Abstract:
OBJECTIVES:Unlike the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) guideline, the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline has recommended a shift in hypertension definition from blood pressure (BP) 140/90-130/80 mmHg. Further, they proposed somewhat different indications for antihypertensive medication. No data are available on the comprehensive impact of these guidelines in European countries, where physicians do not always follow guidelines from their own continent. We estimated the prevalence of hypertension, recommendations for antihypertensive medication, and cardiometabolic goals achieved in Spain using the ESC/ESH versus ACC/AHA guidelines. METHODS:We analyzed data from a national survey on 12074 individuals representative of the population aged at least 18 years in Spain. BP was measured with standardized procedures. RESULTS:According to the ESC/ESH and ACC/AHA guidelines, hypertension prevalence was 33.1% (95% confidence interval: 32.2-33.9%) and 46.9% (46.0-47.8%), respectively, and antihypertensive medication was recommended for 33.5% (32.7-34.3%) and 37.2% (36.3-38.1%) of adults, respectively. This represents 5.3 more million hypertensive patients and 1.4 more million candidates for medication (for a 40-million-adults' country) using the ACC/AHA versus the ESC/ESH guideline. Participants who were hypertensive under the ACC/AHA but not the ESC/ESH guideline achieved less frequently some cardiometabolic goals (e.g. nonsmoking, reduced salt consumption, LDL cholesterol if hypercholesterolemic, lifestyle medical advice, and treatment with renin-angiotensin-system blockers where indicated) than those who were hypertensive under the ESC/ESH guideline. CONCLUSION:The implementation of the ACC/AHA versus the ESC/ESH guideline would result in a substantial increase in the prevalence of hypertension and the number of adults who should receive medication. There is room for improvement in lifestyles and cardioprotective treatment in individuals with BP of 130-9/80-9 mmHg whether they are called hypertensive (ACC/AHA) or not (ESC/ESH). We suggest that clinical-practice guidelines should consider the public health and costs implications, and not only the evidence on effectiveness and cost-effectiveness, of their recommendations.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Gijón-Conde T,Sánchez-Martínez M,Graciani A,Cruz JJ,López-García E,Ortolá R,Rodríguez-Artalejo F,Banegas JRdoi
10.1097/HJH.0000000000002065subject
Has Abstractpub_date
2019-07-01 00:00:00pages
1393-1400issue
7eissn
0263-6352issn
1473-5598pii
00004872-201907000-00012journal_volume
37pub_type
杂志文章abstract:OBJECTIVES:We hypothesized that the aldosterone: renin ratio (ARR) predicts the antihypertensive response to mineralocorticoid receptor antagonist, spironolactone (SPIRO), when compared with bendroflumethiazide (BFZ). METHODS:We conducted a randomized, crossover, trial on hypertensive patients with either high ARR (HA...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/HJH.0b013e328332b79b
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:C-reactive protein (CRP) both reflects and participates in inflammation, and its circulating concentration marks cardiovascular risk. Here we sought to understand the role of heredity in determining CRP secretion. METHODS:CRP, as well as multiple facets of the metabolic syndrome, were measured in a series o...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328011753e
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVES:Immigration studies can shed light on hypertension development and reveal high-risk populations. To this end, we investigated the association between age at immigration and hypertension occurrence at adolescence among immigrants to Israel. METHODS:We analyzed cross-sectional data on 2 681 294 adolescents as...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001957
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:We tested the hypothesis that qualitative microalbuminuria (MAU) screening in a practice setting would identify non-diabetic hypertensive patients at high risk of developing cardiovascular disease. DESIGN:We enrolled general practitioners throughout Germany, who obtained histories, physical examinations, and...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199602000-00011
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:It has been suggested that non-invasive aortic stiffness measurements can be used as an indicator of atherosclerosis. The relationships of arterial stiffness with arterial wall hypertrophy and atherosclerosis however, have rarely been investigated in large-scale studies. The present study reports the associat...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200201000-00013
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:To investigate the association of serum uric acid level with the risk for hypertension and Type 2 diabetes. DESIGN:Prospective cohort study. SETTING:Work site in Osaka, Japan. PARTICIPANTS:A total of 6,356 Japanese men, aged 35-60 years with systolic blood pressure < 140 mmHg and diastolic blood pressure <...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200107000-00005
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVE:To determine the blood pressure responses in elderly normotensive men and women to dietary sodium and to the diunsaturated fatty acid dihomogammalinolenic acid (DGLA), which is derived from linoleic acid. DESIGN:Blood pressure responses were assessed in 66 subjects (36 male, 30 female; mean age 65 years) on ...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004872-199312000-00011
更新日期:1993-12-01 00:00:00
abstract:OBJECTIVE:To assess the antihypertensive efficacy and safety of the novel AT1 receptor antagonist, telmisartan, compared with that of enalapril in elderly patients with mild to moderate hypertension. DESIGN:A 26-week, multicenter, double-blind, parallel-group, dosage titration study. METHODS:A total of 278 patients a...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00004872-199917020-00015
更新日期:1999-02-01 00:00:00
abstract::Pinacidil is a new vasodilating compound claimed to increase renal perfusion and function. A preliminary study showed that pinacidil did not sustain renal perfusion through a period of increasing renal vascular resistance in pig-to-rabbit renal xenotransplantation. Accordingly, the effect of pinacidil on renal functio...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198312000-00006
更新日期:1983-12-01 00:00:00
abstract:OBJECTIVE:Blood pressure normally declines during the night ('dipping'); a blunted nocturnal decline is an important cardiovascular risk factor. Marriage may be associated with lower ambulatory blood pressure, although this may be confounded by socio-economic and dietary factors. We examined the association of marital ...
journal_title:Journal of hypertension
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/HJH.0000000000000107
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVES:Enhanced central sympathetic outflow is an indicator of the prognosis of heart failure. Although the central sympatholytic drug moxonidine is an established therapeutic strategy for hypertension, its benefits for hypertensive heart failure are poorly understood. In the present study, we investigated the effe...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328364a2a1
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVES:Several studies have suggested a positive association between serum lipid levels and blood pressure (BP). This study investigated this association in a large population from 12 European countries. METHODS:Data were taken from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001078
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:To examine the association of blood pressure (BP) with cardiovascular mortality in real-world settings and investigate whether that association varied by use of antihypertensive medication at baseline. METHODS:Data from 27 728 Japanese men and women, aged 40-79 years, free of stroke, coronary heart disease, ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002073
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:In some patients with aortic stenosis left-ventricular hypertrophy exceeds what is needed to sustain the hemodynamic load imposed by the aortic stenosis, a condition named inappropriately high left-ventricular mass (iLVM). Although iLVM is associated with increased mortality after aortic valve replacement, pr...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/HJH.0b013e32834f0b00
更新日期:2012-02-01 00:00:00
abstract::Endothelin-1 was infused into the non-dominant brachial artery in two male subjects. We then monitored intra-arterial mean blood pressure, right atrial pressure, the heart rate and forearm blood flow (by plethysmography). Endothelin-1 at a dose of 5 x 10(-14) to 5 x 10(-9) mol, infused over 5 min periods, elicited no ...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1097/00004872-199009000-00004
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:Cerebrovascular myogenic function, which protects the brain from hemorrhagic stroke, is impaired in stroke-prone spontaneously hypertensive rats. Furthermore, myogenic function contributes to very low frequency blood pressure variability and dynamic autoregulation of cerebral blood flow is most effective at ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3282fb81c8
更新日期:2008-06-01 00:00:00
abstract::Vascular Na-K pump activity (ouabain-sensitive 86Rb uptake) and cardiac Na,K-ATPase activity are decreased in rats with one-kidney, one clip and reduced renal mass-saline hypertension. In the present study we measured left ventricular, microsomal Na,K-ATPase activity in rats with two steroid forms of hypertension; one...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198404000-00004
更新日期:1984-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to identify the time of blood pressure (BP) drop in the orthostatic hypotension test, and to propose a realistic and appropriate duration in the orthostatic hypotension test. METHODS:A total of 879 consecutive patients (61-year-old and 44% women) with positive on the orthostatic...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002554
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Some patients with essential hypertension manifest greater than normal urinary excretion of albumin (UAE). Authors of a few retrospective studies have suggested that there is an association between microalbuminuria and cardiovascular risk. OBJECTIVE:To evaluate whether microalbuminuria is associated with a ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199816090-00014
更新日期:1998-09-01 00:00:00
abstract:AIMS:Baroreflex activation therapy (BAT) has recently been shown to reduce muscle sympathetic nerve activity and hospitalization rate while improving clinical variables through 6 months of therapy in patients with heart failure and reduced ejection fraction (HFrEF). The objective of the present study is to extend the i...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1097/HJH.0000000000000603
更新日期:2015-08-01 00:00:00
abstract::: The aim of the current article is to review the current evidence on the role of morning blood pressure (BP) in the management of hypertension. Morning BP surge had been and will continue to be a hot topic of hypertension research. However, more evidence is needed to prove its clinical usefulness in the management of...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/HJH.0000000000001379
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:We examined the relationship between brachial-ankle pulse wave velocity and the development of cardiovascular disease in a general Japanese population. METHODS:A total of 2916 community-dwelling Japanese individuals without history of cardiovascular disease aged at least 40 years were followed up for an aver...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32835c5c23
更新日期:2013-03-01 00:00:00
abstract:RATIONALE:Cicletanine (CIC), an anti-hypertensive compound with direct vascular and natriuretic actions, is especially effective in salt-sensitive hypertension, in which dysregulation of the sodium pump plays an important pathogenic role, and digitalis-like cardiotonic steroids contribute to increased vascular tone. Th...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200018020-00012
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVE:The purposes of this study were: (1) to test whether intravenous infusion of norepinephrine can affect plasma dopamine levels; and (2) to explore to what extent dopamine-2 or alpha 2-receptors play a role in this response. DESIGN:Norepinephrine infusion in man was performed to test whether the increase in no...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract:OBJECTIVE:Although several studies have reported an association between microalbuminuria and pulse wave velocity in patients with hypertension or diabetes, there have been no reports of their significance in apparently healthy individuals. METHODS:Microalbuminuria and brachial-ankle PWV (baPWV) were investigated in a ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32834b5627
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:A previous history of hypertension is overrepresented among patients with ischaemic heart disease. The present study aims at describing the influence of a previous history of hypertension upon the prognosis among patients hospitalized due to acute myocardial infarction. DESIGN:Patients were followed for 1 y...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199210000-00022
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVES:The apolipoprotein epsilon 4 allele (APOE/epsilon 4) increases plasma cholesterol level and the risk for the late onset type of Alzheimer's disease. However, the correlation between hypertension and APOE/epsilon 4 has not yet been clarified. To examine the APOE/epsilon 4 effect in the general population of J...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200210000-00021
更新日期:2002-10-01 00:00:00
abstract:UNLABELLED:PURPOSE IDENTIFICATION: Inter-individual variability in blood pressure response to treatment is well documented, but a clinically useful means to distinguish responders from non-responders has been elusive. With the advent of new technologies and genomic knowledge, more investigators are seeking to identify ...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/01.hjh.0000173510.52987.68
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:Elevated blood pressure (BP) is associated with cardiovascular mortality. BP variability (BPV) is also associated with cardiovascular mortality. However, most studies evaluated hypertensive patients with a relatively short follow-up. We investigated in male workers the association between BPV and long-term al...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002447
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:Hypertensive nephropathy is one of the major causes of chronic kidney disease (CKD). Bisphenol A (BPA) is associated with elevated blood pressure and urinary albuminuria. The aim of this study is to evaluate the association between serum BPA with the progression of CKD in patients with primary hypertension. ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000780
更新日期:2016-02-01 00:00:00