Implementation of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline

Abstract

The 2017 American College of Cardiology/AHA Hypertension Guideline recognizes the growing burden of cardiometabolic risk and disease. Guideline authors have integrated available public health and clinical trial evidence to mitigate the growing health and economic burden of cardiovascular disease, which include lowering the threshold for diagnosing hypertension to 130/80 and the treatment target to <130/<80. The guideline also recognizes that individuals with elevated BP of 120 to 129/<80 often have masked hypertension and higher risk for progression to hypertension than those with normal BP <120/<80. Out-of-office BP monitoring, attention to lifestyle modification, and regular follow-up are recommended for this group. Nearly half of US adults have hypertension based on the new definition, and more than half have either hypertension or elevated BP, which leads to an additional burden on a fully loaded primary healthcare workforce. Integration of public health and population healthcare efforts in addition to healthcare redesign are required to realize more evidence-based benefits of cardiovascular health promotion and disease prevention. Healthy People 2020 and AHA 2020 Impact Goals, which include Lifes Simple 7, and Target:BP identify key process and outcome variables required for success.