What Is the Definition of Hypertension by American Heart Association

Overall, 10.22% of all strokes and 14.34% of ischemic strokes were due to stage 1 hypertension. The relatively large RAP observed in older participants may be important for the prevention of stroke. Our findings call on the government and health systems to take public health initiatives to strengthen the management of stage 1 hypertension among older rural Chinese to reduce the incidence of stroke and the burden of stroke on treatment, medical costs and the national economy. Although both are signs of health, blood pressure and heart rate (pulse) are two separate measures. Learn more about the difference between blood pressure and heart rate. Many countries in Europe or Asia have carefully considered whether the new guideline is appropriate for location between geographic regions and ethnicities [13-15]. Data from the Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA)/Cooperative Health Research in the Region of Augsburg (KORA) cohort study with 11,603 subjects showed that stage 1 hypertension did not increase the risk of cardiovascular mortality (CVD) compared to normal blood pressure [13]. Similarly, another study showed that newly defined stage 1 hypertension was not associated with an increased risk of CVD mortality in Chinese Singaporeans aged 46 to 85 years [14]. In contrast, stronger associations with subsequent cardiovascular events were observed in patients with initial hypertension 1 in young Korean adults [15].

The results of previous studies conducted in various countries on the risk of CVD associated with stage 1 hypertension in the new guideline are controversial. These studies did not specifically analyze the relationship between high blood pressure and stage 1 stroke and its subtypes, especially in rural older Chinese. Keywords: AHA17, AHA Annual Scientific Sessions, Antihypertensive Agents, Blood Pressure Monitoring, Ambulatory, White Coat Hypertension, Blood Pressure, Risk Factors, Prehypertension, National Heart, Lung and Blood Institute (USA), Prevalence, Cardiovascular Disease, Stress, Psychological, High Blood Pressure, Stroke, Systole, Hypercholesterolemia, Myocardial Infarction, Diabetes Mellitus, Renal Failure, Chronic, Hospitalization, Social class, Lifestyle, Healthcare personnel, Cholesterol in adults at increased risk of heart failure (CI), optimal blood pressure in patients with high blood pressure should be less than 130/80 mm Hg. Blood pressure was measured by qualified research personnel according to the American Heart Association protocol. Participants were asked to rest while sitting for at least 5 minutes, and blood pressure was monitored using a standardized automatic electronic blood pressure monitor (HEM-741C; Omron, Tokyo, Japan). Participants were instructed to avoid alcohol, cigarette, coffee/tea and exercise for at least 30 minutes before blood pressure measurement. For each participant, blood pressure was measured 3 times by qualified research personnel and the average of the BP values was calculated for the current analysis. According to the 2017 ACC/AHA guideline, participants were divided into four categories: normal (SBP <120 mmHg and DBP <80 mmHg), high (120 mmHg ≤SBP ≤129 mmHg and DBP <80 mmHg), stage 1 hypertension (130 mmHg ≤SBP ≤139 mmHg or 80 mmHg ≤BP ≤89 mmHg) and stage 2 hypertension (SBP ≥140 mmHg/DBP ≥90 mmHg or taking antihypertensive drugs). For adults whose office BP is not treated and who are consistently between 120 mm Hg and 129 mm Hg for BPS or between 75 mm Hg and 79 mm Hg for BPD, screening for masked hypertension with home BP monitoring (or ABPM) is useful. Women with high blood pressure who become pregnant should not be treated with ACE inhibitors, ARBs or direct renin inhibitors. After a kidney transplant, it makes sense to treat patients with high blood pressure with a blood pressure target of less than 130/80 mm Hg. Adults with high blood pressure and chronic renal failure (CKD) should be treated with a blood pressure target of less than 130/80 mm Hg.

In adults with an untreated SBP greater than 130 mm Hg but less than 160 mm Hg or a BPD greater than 80 mm Hg but less than 100 mm Hg, it makes sense to examine either ABPM (ambulatory BPD monitoring) or LMWH (BPM at home) during the day before the diagnosis of high blood pressure. Table 2 presents the multivariate risk models proportional to Cox for stroke risk relative to different BP values. After additional adjustment for age, gender, ethnicity, education and other cardiovascular confounders, the result showed that the HR (95% CI) for all ischemic strokes and strokes was 1.45 (1.11-1.90) and 1.65 (1.17-2.33) (Model 3) respectively. There was no statistical evidence of the association between stage 1 hypertension and the increased risk of haemorrhagic stroke. Patients with stage 2 hypertension had an increased risk of stroke (HR, 2.04; 95% CI: 1.59–2.63), ischemic stroke (HR, 2.35; 95% CI: 1.70–3.25) or haemorrhagic stroke (HR, 1.71; 95% CI: 1.12–2.60). In women, the HR (95% CI) associated with stage 1 hypertension was 2.83 (1.57-5.10) for all strokes, 2.91 (1.43-5.89) for ischemic strokes, each compared to the normal BP group. This association was not observed in men (Supplement Table 4). RAP (95% CI) results for all strokes, ischemic strokes and hemorrhagic strokes associated with stage 1 hypertension were 10.22% (2.64% -18.56%), 14.34% (4.23% -25.41%) and 4.23% (-7.17% -17.99% respectively). The ACC/AHA guidelines eliminate the classification of prehypertension and divide it into two steps [27, 28]: (1) increase in blood pressure (BP) with systolic pressure between 120 and 129 mm Hg and diastolic pressure below 80 mm Hg, and (2) stage 1 hypertension with systolic pressure of 130 to 139 mm Hg or diastolic pressure of 80 to 89 mm Hg. The guidelines eliminate the category of prehypertension and classify patients as high hypertension (120-129 and less than 80) or stage I (130-139 or 80-89).

While previous guidelines classified 140/90 mm Hg as stage 1 hypertension, this level is classified as stage 2 hypertension under the new guidelines. In addition, the guidelines emphasize the importance of using the right technique to measure blood pressure. recommend the use of blood pressure monitoring at home with validated devices; and highlight the value of adequate training for health care providers to discover “white coat hypertension.” Other changes include: Adults with HFrEF (IC with reduced ejection fraction) and high blood pressure should be prescribed GDMT (guideline-guided management and treatment), which is titrated to achieve blood pressure below 130/80 mm Hg. During a median follow-up period of 12.5 years, we observed 1,159 first strokes (774 ischemic, 360 hemorrhagic and 25 uncategorized). The number and percentage of new stroke cases and its subtypes according to BP values are listed in Supplementary Table 3. As shown in Figure 2, the incidence of stroke (Figure 2(a)) per 1,000 person-years of stage 2 hypertension (26.3; 95% CI: 24.5 to 28.1) was elevated, followed by stage 1 hypertension (17.0; 95% CI: 14.9 to 19.1), high blood pressure (11.8; 95% CI: 8.8 to 14.8) and normal blood pressure (11.2; 95% CI: 8.5 to 13.9). Similar results have been observed in ischemic stroke (Figure 2(b)). However, the incidence of hemorrhagic stroke (Figure 2(c)) was lowest in terms of high blood pressure (3.4; 95% CI: 1.7–5.1), compared with normal blood pressure (4.3; 95% CI: 2.6–6.0), stage 1 hypertension (5.4; 95% CI: 4.1–6.7) and stage 2 hypertension (9.3; 95% CI: 8.1–10.5).

The more plaque and damage increases, the narrower the inside of the arteries becomes (smaller), which increases blood pressure and triggers a vicious cycle that further damages your arteries, heart, and the rest of your body. This can eventually lead to other conditions ranging from arrhythmia to heart attack and stroke. The new guidelines – the first comprehensive set since 2003 – lower the definition of high blood pressure to account for complications that can occur at a lower number and to allow for earlier intervention. The new definition will lead to high blood pressure in nearly half of the U.S. adult population (46%), with the biggest impact expected in young people. .