Projection of new thresholds for hypertension to outpatient clinic patients and impact of risk factors: a cross-sectional study
Autor(a) principal: | |
---|---|
Data de Publicação: | 2019 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | São Paulo medical journal (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802019000400356 |
Resumo: | ABSTRACT BACKGROUND: The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines on hypertension management recommend new stage 1 hypertension thresholds (130-139/80-89 mmHg) for starting antihypertensive treatment. OBJECTIVE: To analyze the impact of the 2017 ACC/AHA guidelines on patients’ diagnoses within daily practice, in comparison with management using the 2018 European hypertension guidelines, regarding the new thresholds. DESIGN AND SETTING: Cross-sectional study conducted in a hypertension outpatient clinic at a tertiary-level public hospital. METHODS: The diagnosis of hypertension was defined separately using each guideline. The participants were patients who were attending the hypertension clinic, who were evaluated using the thresholds of two guidelines, based on cardiovascular risk factors, including age, gender, smoking status, diabetes mellitus, dyslipidemia, obesity, osteoporosis, chronic renal failure and family history of hypertension. RESULTS: After adapting the guidelines to the blood pressure values of our sample, 74.5% (n = 277) of the patients were diagnosed as hypertensive according to the blood pressure classification of the European Society of Cardiology (ESC) guidelines published in 2018, while 91.1% (n = 339) of the patients were hypertensive according to the new 2017 ACC/AHA guidelines. Multivariate regression analysis revealed that the significant demographic and cardiovascular risk factors associated with hypertension, based on the 2018 European Society of Hypertension (ESH)/ESC guidelines, were age (odds ratio, OR: 1.027; 95% confidence interval, CI: 1.001-1.054; P = 0.042), obesity (OR: 4.534; 95% CI: 1.830-11.237; P = 0.001) and family history of hypertension (OR: 2.199; 95% CI: 1.252-3.862; P = 0.006). CONCLUSIONS: The factors associated with the definition of hypertension may vary through changing the threshold values. |
id |
APM-1_4ae58015fc5186974f014976b3035809 |
---|---|
oai_identifier_str |
oai:scielo:S1516-31802019000400356 |
network_acronym_str |
APM-1 |
network_name_str |
São Paulo medical journal (Online) |
repository_id_str |
|
spelling |
Projection of new thresholds for hypertension to outpatient clinic patients and impact of risk factors: a cross-sectional studyBlood pressureHypertensionGuidelineABSTRACT BACKGROUND: The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines on hypertension management recommend new stage 1 hypertension thresholds (130-139/80-89 mmHg) for starting antihypertensive treatment. OBJECTIVE: To analyze the impact of the 2017 ACC/AHA guidelines on patients’ diagnoses within daily practice, in comparison with management using the 2018 European hypertension guidelines, regarding the new thresholds. DESIGN AND SETTING: Cross-sectional study conducted in a hypertension outpatient clinic at a tertiary-level public hospital. METHODS: The diagnosis of hypertension was defined separately using each guideline. The participants were patients who were attending the hypertension clinic, who were evaluated using the thresholds of two guidelines, based on cardiovascular risk factors, including age, gender, smoking status, diabetes mellitus, dyslipidemia, obesity, osteoporosis, chronic renal failure and family history of hypertension. RESULTS: After adapting the guidelines to the blood pressure values of our sample, 74.5% (n = 277) of the patients were diagnosed as hypertensive according to the blood pressure classification of the European Society of Cardiology (ESC) guidelines published in 2018, while 91.1% (n = 339) of the patients were hypertensive according to the new 2017 ACC/AHA guidelines. Multivariate regression analysis revealed that the significant demographic and cardiovascular risk factors associated with hypertension, based on the 2018 European Society of Hypertension (ESH)/ESC guidelines, were age (odds ratio, OR: 1.027; 95% confidence interval, CI: 1.001-1.054; P = 0.042), obesity (OR: 4.534; 95% CI: 1.830-11.237; P = 0.001) and family history of hypertension (OR: 2.199; 95% CI: 1.252-3.862; P = 0.006). CONCLUSIONS: The factors associated with the definition of hypertension may vary through changing the threshold values.Associação Paulista de Medicina - APM2019-07-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802019000400356Sao Paulo Medical Journal v.137 n.4 2019reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APM10.1590/1516-3180.2019.0111220719info:eu-repo/semantics/openAccessAydogan,UmitDoganer,Yusuf CetinEbiloglu,AsliGok,Deniz EnginCirpan,EbruSaglam,Kenaneng2020-01-06T00:00:00Zoai:scielo:S1516-31802019000400356Revistahttp://www.scielo.br/spmjhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2020-01-06T00:00São Paulo medical journal (Online) - Associação Paulista de Medicinafalse |
dc.title.none.fl_str_mv |
Projection of new thresholds for hypertension to outpatient clinic patients and impact of risk factors: a cross-sectional study |
title |
Projection of new thresholds for hypertension to outpatient clinic patients and impact of risk factors: a cross-sectional study |
spellingShingle |
Projection of new thresholds for hypertension to outpatient clinic patients and impact of risk factors: a cross-sectional study Aydogan,Umit Blood pressure Hypertension Guideline |
title_short |
Projection of new thresholds for hypertension to outpatient clinic patients and impact of risk factors: a cross-sectional study |
title_full |
Projection of new thresholds for hypertension to outpatient clinic patients and impact of risk factors: a cross-sectional study |
title_fullStr |
Projection of new thresholds for hypertension to outpatient clinic patients and impact of risk factors: a cross-sectional study |
title_full_unstemmed |
Projection of new thresholds for hypertension to outpatient clinic patients and impact of risk factors: a cross-sectional study |
title_sort |
Projection of new thresholds for hypertension to outpatient clinic patients and impact of risk factors: a cross-sectional study |
author |
Aydogan,Umit |
author_facet |
Aydogan,Umit Doganer,Yusuf Cetin Ebiloglu,Asli Gok,Deniz Engin Cirpan,Ebru Saglam,Kenan |
author_role |
author |
author2 |
Doganer,Yusuf Cetin Ebiloglu,Asli Gok,Deniz Engin Cirpan,Ebru Saglam,Kenan |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Aydogan,Umit Doganer,Yusuf Cetin Ebiloglu,Asli Gok,Deniz Engin Cirpan,Ebru Saglam,Kenan |
dc.subject.por.fl_str_mv |
Blood pressure Hypertension Guideline |
topic |
Blood pressure Hypertension Guideline |
description |
ABSTRACT BACKGROUND: The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines on hypertension management recommend new stage 1 hypertension thresholds (130-139/80-89 mmHg) for starting antihypertensive treatment. OBJECTIVE: To analyze the impact of the 2017 ACC/AHA guidelines on patients’ diagnoses within daily practice, in comparison with management using the 2018 European hypertension guidelines, regarding the new thresholds. DESIGN AND SETTING: Cross-sectional study conducted in a hypertension outpatient clinic at a tertiary-level public hospital. METHODS: The diagnosis of hypertension was defined separately using each guideline. The participants were patients who were attending the hypertension clinic, who were evaluated using the thresholds of two guidelines, based on cardiovascular risk factors, including age, gender, smoking status, diabetes mellitus, dyslipidemia, obesity, osteoporosis, chronic renal failure and family history of hypertension. RESULTS: After adapting the guidelines to the blood pressure values of our sample, 74.5% (n = 277) of the patients were diagnosed as hypertensive according to the blood pressure classification of the European Society of Cardiology (ESC) guidelines published in 2018, while 91.1% (n = 339) of the patients were hypertensive according to the new 2017 ACC/AHA guidelines. Multivariate regression analysis revealed that the significant demographic and cardiovascular risk factors associated with hypertension, based on the 2018 European Society of Hypertension (ESH)/ESC guidelines, were age (odds ratio, OR: 1.027; 95% confidence interval, CI: 1.001-1.054; P = 0.042), obesity (OR: 4.534; 95% CI: 1.830-11.237; P = 0.001) and family history of hypertension (OR: 2.199; 95% CI: 1.252-3.862; P = 0.006). CONCLUSIONS: The factors associated with the definition of hypertension may vary through changing the threshold values. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-07-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802019000400356 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802019000400356 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1516-3180.2019.0111220719 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
dc.source.none.fl_str_mv |
Sao Paulo Medical Journal v.137 n.4 2019 reponame:São Paulo medical journal (Online) instname:Associação Paulista de Medicina instacron:APM |
instname_str |
Associação Paulista de Medicina |
instacron_str |
APM |
institution |
APM |
reponame_str |
São Paulo medical journal (Online) |
collection |
São Paulo medical journal (Online) |
repository.name.fl_str_mv |
São Paulo medical journal (Online) - Associação Paulista de Medicina |
repository.mail.fl_str_mv |
revistas@apm.org.br |
_version_ |
1754209266694094848 |