Increase in Hypertensive Stroke Survivors After Implementation of New Hypertension Guidelines

With the implementation of the 2017 ACC/AHA hypertension guidelines, there may be a significant increase in stroke survivors with hypertension.

A greater proportion of people with hypertension who had a stroke and achieved blood pressure targets recommended in the 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines survived during 2003 to 2014 compared with patients who achieved blood pressure targets recommended in the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) guidelines, according to a study published in the Journal of the American Heart Association.

In the JNC7 guidelines, the consensus committee recommends hypertension pharmacologic treatment for those who had a stroke and had systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg. The JNC7 defined hypertension as SBP ≥140 mmHg or DBP ≥90 mmHg.

The updated 2017 ACC/AHA guidelines, however, lowered the blood pressure cutoff for hypertension in patients at risk for stroke to SBP ≥130 mmHg or DBP ≥80 mmHg. In addition, the 2017 ACC/AHA guidelines recommend initiating pharmacologic therapy for these individuals to achieve SBP/DBP target of <130/80 mmHg.

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