Projection of new thresholds for hypertension to outpatient clinic patients and impact of risk factors: a cross-sectional study.

Autor:	Aydogan U; MD. Associate Professor, Department of Family Medicine, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey., Doganer YC; MD. Associate Professor, Department of Family Medicine, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey., Ebiloglu A; MD. Family Physician, Oran Outpatient Clinic, Primary Care and Family Health Center, Ankara, Turkey., Gok DE; MD. Endocrinologist, Department of Endocrinology and Metabolic Diseases, ARTE Surgery Hospital, Ankara, Turkey., Cirpan E; MD. Family Physician, Foca Naval Base Outpatient Clinic, Primary Care and Family Health Center, Izmir, Turkey., Saglam K; MD. Professor, Department of Internal Medicine, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey.
Jazyk:	angličtina
Zdroj:	Sao Paulo medical journal = Revista paulista de medicina [Sao Paulo Med J] 2019 Oct 31; Vol. 137 (4), pp. 356-362. Date of Electronic Publication: 2019 Oct 31 (Print Publication: 2019).
DOI:	10.1590/1516-3180.2019.0111220719
Abstrakt:	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.
Databáze:	MEDLINE
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