Abstract
Introduction: The American Heart Association/American College of Cardiology has published new guidelines for hypertension in 2017. These guidelines change the criteria to classify patients with hypertension. There has not yet been a study that analyzes the consequences of these changes in developing countries. The objective of our study was to characterize changes in the classification of hypertension with the new guidelines among Peruvian patients and to determine the factors associated with being newly diagnosed as hypertensive. Methods: An analytical cross-sectional investigation was carried out, which was based on the secondary analysis of the data of hypertension. We compared certain variables including using antihypertensive medication, region, and other sociodemographic characteristics. We performed a descriptive analysis of the variables shown as frequency and percentage. P values that were less than 0.05 were considered statistically significant, obtained using a multivariate analysis. Results: Of the 5,615 patients in this cohort, with the old criteria 4,915 (87.5%) did not have the diagnosis of hypertension; however, with the new criteria 1,415 (25%) will be diagnosed with hypertension. 467 (9%) of patients who were not taking medications and 85 (32%) of patients who were taking medications will switch from having high-normal blood pressure to grade 1 hypertension, with the new guideline. The recent diagnosis of hypertension was associated with sex (p <0.001), age (p <0.001), being overweight (p <0.001), physical activity (p = 0.010), smoking (p = 0.031), and a history of diabetes mellitus (p <0.001). When adjusted for pharmacotherapy, only sex (p <0.001), age (p <0.001), being overweight (p <0.001), and physical activity (p = 0.001) remained statistically significant. Conclusions: The new criteria increased the percentage of patients that now will be classified with hypertension. This should be accompanied by effective politics in education, surveillance, and adequate treatment of the health care system.
Highlights
The American Heart Association/American College of Cardiology has published new guidelines for hypertension in 2017
Study design An analytical cross-sectional investigation was carried out, which was based on the secondary analysis of the data; this is because the primary data was used to describe and find associations of chronic pathologies and others related to blood pressure in various populations of Peru
We included patients of major age who agreed to participate in the study and signed the informed medical consent, excluding those who had acute symptoms that alter the hemodynamic balance, pregnancy, any anatomical defects or surgical procedures that could potentially interfere with the proper access to blood flow to the upper arm, patients that lived less than half a year in the city where the clinic was located, and patients who had not adequately answered major questions or answered in repetitive patterns
Summary
The American Heart Association/American College of Cardiology has published new guidelines for hypertension in 2017. In November 2017, the American Heart Association (AHA) in conjunction with the American College of Cardiology (ACC) made one of the most important changes of the last decades in this subject.10 In these changes, the cut-off point for the diagnosis of hypertension is reduced, which generates a new global panorama for the diagnosis, treatment, and overall control of HTN.. The cut-off point for the diagnosis of hypertension is reduced, which generates a new global panorama for the diagnosis, treatment, and overall control of HTN.11 This has not yet been evaluated in prospective studies in developing countries, but it is important to determine how much the changes that have been established can affect the populations so that efforts to analyze data that can give an idea of the change that may occur. Another concern about this paper is why it is a prospective study mentioned in the introduction section, in study design “an analytical cross-sectional” is referred to? Please clarify this confusion
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