The choices we make every day can have a lasting effect on our heart and vascular health. Absolute cardiovascular risk is utilized, for the first time, to determine high-risk status when BP 130–139/80–89 mm Hg (Stage 1 hypertension) and high-risk patient characteristics/co-morbidities are absent including age 65 and older, diabetes, chronic kidney disease, known cardiovascular disease; high-risk individuals initiate drug therapy when BP ≥ 130/80 mm Hg. However, ESC/ESH recommends it as initial therapy in patients at ≥140/90 mm Hg and the ACC/AHA recommends a single-pill combination in patients with >20/10 mm Hg above BP goal. Beckett NS, Peters R, Fletcher AE, et al. Pharmacologic treatment of hypertension in adults aged 60 Years or older to higher versus lower blood pressure targets: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. 1.5. Latest guidelines for hypertension: adopt and adapt. Organization of the Writing Committee e599 3. Treatment of hypertension in patients 80 years of age or older. The guideline is a compilation of the most important studies and guidelines for … In this review, we will discuss the common features and explore some of the major differences between the guidelines. DOI: 10.1161/ HYP.0000000000000065. Abbreviations e601 4. Since 1980, the American College of Cardiology (ACC) and American Heart Association (AHA) have translated scientific evidence into clinical practice guidelines (guidelines) with recommendations to improve cardiovascular health. The JNC 8 guidelines contained nine recommendations surrounding the three critical questions. 1.3. Hypertension in adults The 2017 ACC and AHA updated guidelines were endorsed by many other organizations. Both strongly recommend lower BP targets for high-risk patients and place a similar emphasis on proper BP measurement and technique, laboratory and diagnostic testing, lifestyle and behavioral changes, and pharmacological management. Williams B, Mancia G, Spiering W, et al. In a corresponding analysis of the guidelines' impact, Paul Muntner, PhD, et al., suggests "the 2017 ACC/AHA hypertension guideline has the potential to increase hypertension awareness, encourage lifestyle modification and focus antihypertensive medication initiation and intensification on US adults with high CVD risk." © 2019 The Authors. Treatment should be initiated with two drugs having complementary mechanisms of action when blood pressure is >20/10 mm Hg above goal. 2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Introduction e598 1. Grundy SM, Stone NJ, Bailey AL; et al. College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. The guideline breaks new ground with some of its recommendations. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. All rights reserved. Hypertension is diagnosed when blood pressure is consistently ≥130 and/or ≥80 mm Hg. Adopting a heart healthy eating plan early in life, getting more exercise, avoiding tobacco and managing known risk factors are among the key recommendations in the 2019 Primary Prevention of Cardiovascular Disease guideline from the ACC/AHA. Principal Areas of Agreement Between American and European Guidelines, Primary Differences Between American and European Guidelines, After careful review of the two guidelines, we find more agreement with the Europeans than major differences. 2.1. Hypertension. The most controver- 2019;140:e596–e646. By continuing you agree to the use of cookies. © 2020 American College of Cardiology Foundation. Yang E, Sharma G, Ram V. American and European hypertension guidelines: finding common ground. Class of Recommendation and Level of Evidence e600 6. Thus, the ACC/AHA guideline recommends medical therapy for atherosclerotic renal artery obstruction in most patients; however, the guideline suggests it is reasonable to consider renal artery revascularization in the following situations (expert opinion): 1) refractory hypertension (uncontrolled BP while taking ≥5 drugs, one of which is a diuretic), 2) worsening renal function … Scope of the Guideline e599 5. Lim SS, Vos T, Flaxman AD, et al. Ram CVS. Arnett et al 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease Circulation.

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