• Umit Aydogan, Yusuf Cetin Doganer, Asli Ebiloglu, Deniz Engin Gok, Ebru Cirpan, and Kenan Saglam.
• MD. Associate Professor, Department of Family Medicine, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey.
• Sao Paulo Med J. 2019 Jan 1; 137 (4): 356362356-362.

BackgroundThe 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.ObjectiveTo 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 SettingCross-sectional study conducted in a hypertension outpatient clinic at a tertiary-level public hospital.MethodsThe 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.ResultsAfter 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).ConclusionsThe factors associated with the definition of hypertension may vary through changing the threshold values.

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