Agreement between 2017 ACC/AHA Hypertension Clinical Practice Guidelines and Seventh Report of the Joint National Committee Guidelines to Estimate Prevalence of Postmenopausal Hypertension in a Rural Area of Bangladesh: A Cross Sectional Study

Prevalence of hypertension in Iran: An updated systematic review and meta-analysis of community-based studies

Background

Hypertension (HTN) is one of the primary risk factors for heart disease and stroke worldwide. The present meta-analysis was aimed to systematically review and statistically estimate the prevalence rate of pre-hypertension (PHTN) and HTN in the Iranian child/adolescent and adult age groups.

Methods

In this study, four International databases, including PubMed, Scopus, Web of Science, and Cochrane, as well as three Iranian databases, including SID, Magiran, and IranMedex, were separately investigated for articles published before January 2021. Also, we estimated the pooled effect size for the prevalence of PHTN and HTN in children/adolescent and adult age groups. Stata software (version 14.0) was used for all statistical analyses.

Results

From a total of 1185 articles found in database searches, fifty-one were included in the meta-analysis. The prevalence of HTN in the Iranian adult population was 26.26% (25.11 % and 26.22 % for women and men, respectively). Meanwhile, the prevalence of PHTN and HTN in the child/adolescent age group was 8.97% (95% CI 7.33 - 10.61) and 8.98% (95% CI 7.59 - 10.36), respectively.

Conclusions

This study provides information which can be used for various purposes, including study designing. Further nationwide surveys should be carried out to obtain accurate information on the HTN prevalence rate, particularly based on the American College of Cardiology /American Heart Association guidelines in the Iranian population.

Prevalence of high blood pressure under 2017 ACC/AHA guidelines: a systematic review and meta-analysis

To understand the prevalence of high blood pressure among the general adult population under the new diagnostic criteria. PubMed and Embase databases were systematically searched. Two investigators independently performed data extraction and quality assessment, and the disagreements were resolved by consensus with a third investigator. The random-effects model was performed to pool the prevalence of high blood pressure among the population. Subgroup and meta-regression analyses were performed to explore the source of heterogeneity. The study protocol has been registered with PROSPERO, number CRD42019147330. In total, 52 articles included in the meta-analysis with a total of 54 studies. An obvious increase in the prevalence of high blood pressure was identified by the application of new diagnostic criteria. The pooled prevalence of high blood pressure among the population was 53.01% (95% confidence interval 51.13-54.88%). Subgroup analysis showed that the WHO region, national, and age could significantly influence the prevalence of hypertension (P < 0.01). Meta-regression analyses revealed that study quality and sex ratio (male, %) did not contribute to the heterogeneity of the results (P > 0.05). The sensitivity analysis showed that the results were stable. With the use of new diagnostic criteria, the prevalence of high blood pressure has shown an upward trend, especially in Europe countries. Prevention and control measures should focus more on improving cardiovascular and cerebrovascular status in Europe countries. Standard electronic blood pressure monitors were recommended for use in future studies, and at least two more readings should be taken during a visit.

Prevalence of hypertension and controlled hypertension among United States adults: Evidence from NHANES 2017-18 survey

BACKGROUND

This study aims to compare the prevalence of hypertension (HTN) and controlled hypertension (CHTN) in US adults and determine the absolute difference in the prevalence of HTN and CHTN between the JNC7 and ACC/AHA 2017 guidelines.

METHODS

Data for this study were derived from the most recent cycle of the National Health and Nutrition Examination Survey (NHANES) 2017-2018. After excluding participants with missing systolic blood pressure (BP) or diastolic BP and aged <18 years, 4730 participants were included in the final analyses. BP was defined as the average of the first three measurements. The prevalence of HTN and CHTN, including absolute differences of these prevalences, were estimated using both JNC7 and ACC/AHA 2017 guidelines.

RESULTS

The overall weighted prevalence of HTN was 31.7% (95% CI: 28.7-34.8) based on JNC7, while the corresponding prevalence was 45.6% (95% CI: 43.0-48.3) when new guideline of ACC/AHA was used. Of the people who had HTN according to the JNC7 and ACC/AHA 2017 guidelines, 48.2% (95% CI: 44.4-52.0) and 21.0% (95% CI: 18.1-24.2) had a controlled blood pressure level, respectively. When blood pressure was assessed using both guidelines, the greatest absolute increase in rates of HTN and CHTN was 17.4% and 30.0% in people aged 40-59 years, respectively.

CONCLUSION

Given the high burden of disease due to complications arising from untreated HTN, as well as the higher costs of untreated disease, new guidelines have important public health implications to early detection of patients at risk and prevent complications across different populations.