Systematic review for the 2017 ACC/AHA/AAPA/ABC/ ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults a report of the American College of Cardiology/American Heart Association Task Force on Clinical practice guidelines

American College of Cardiology, American College of Cardiology/American Heart Association

Research output: Contribution to journalReview article

34 Citations (Scopus)

Abstract

Objective-To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy? Methods-Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question. We performed analyses using traditional frequentist statistical and Bayesian approaches, including random-effects Bayesian network meta-analyses. Results-Our results suggest that: 1) There is a modest but significant improvement in systolic BP in randomized controlled trials of self-measured BP versus usual care at 6 but not 12 months, and for selected patients and their providers self-measured BP may be a helpful adjunct to routine office care. 2) systolic BP lowering to a target of <130 mm Hg may reduce the risk of several important outcomes including risk of myocardial infarction, stroke, heart failure, and major cardiovascular events. No class of medications (ie, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, calcium channel blockers, or beta blockers) was significantly better than thiazides and thiazide-like diuretics as a first-line therapy for any outcome.

Original languageEnglish (US)
Pages (from-to)E116-E135
JournalHypertension
Volume71
Issue number6
DOIs
StatePublished - Jun 1 2018

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Proliferating Cell Nuclear Antigen
Advisory Committees
Practice Guidelines
Guidelines
Blood Pressure
Hypertension
Antihypertensive Agents
Randomized Controlled Trials
Thiazides
Sodium Chloride Symporter Inhibitors
Bayes Theorem
Angiotensin Receptor Antagonists
Calcium Channel Blockers
Angiotensin-Converting Enzyme Inhibitors
PubMed
Meta-Analysis
Therapeutics
Software
Heart Failure
Stroke

Keywords

  • AHA Scientific Statements
  • Antihypertensive drug class
  • Blood pressure
  • Cardiovascular disease
  • Evidence Review Committee
  • Home blood pressure monitoring
  • Hypertension
  • Meta-analysis
  • Risk reduction
  • Targets
  • Treatment outcomes

ASJC Scopus subject areas

  • Internal Medicine

Cite this

@article{f86aefa6a081416c894b16b56a399398,
title = "Systematic review for the 2017 ACC/AHA/AAPA/ABC/ ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults a report of the American College of Cardiology/American Heart Association Task Force on Clinical practice guidelines",
abstract = "Objective-To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy? Methods-Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question. We performed analyses using traditional frequentist statistical and Bayesian approaches, including random-effects Bayesian network meta-analyses. Results-Our results suggest that: 1) There is a modest but significant improvement in systolic BP in randomized controlled trials of self-measured BP versus usual care at 6 but not 12 months, and for selected patients and their providers self-measured BP may be a helpful adjunct to routine office care. 2) systolic BP lowering to a target of <130 mm Hg may reduce the risk of several important outcomes including risk of myocardial infarction, stroke, heart failure, and major cardiovascular events. No class of medications (ie, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, calcium channel blockers, or beta blockers) was significantly better than thiazides and thiazide-like diuretics as a first-line therapy for any outcome.",
keywords = "AHA Scientific Statements, Antihypertensive drug class, Blood pressure, Cardiovascular disease, Evidence Review Committee, Home blood pressure monitoring, Hypertension, Meta-analysis, Risk reduction, Targets, Treatment outcomes",
author = "{American College of Cardiology} and {American College of Cardiology/American Heart Association} and Reboussin, {David M.} and Allen, {Norrina B.} and Griswold, {Michael E.} and Eliseo Guallar and Yuling Hong and Lackland, {Daniel T.} and Miller, {Edgar R.} and Tamar Polonsky and Thompson-Paul, {Angela M.} and Suma Vupputuri and Levine, {Glenn N.} and O'Gara, {Patrick T.} and Halperin, {Jonathan L.} and Immediate Past and Al-Khatib, {Sana M.} and Beckman, {Joshua A.} and Birtcher, {Kim K.} and Biykem Bozkurt and Brindis, {Ralph G.} and Cigarroa, {Joaquin E.} and Curtis, {Lesley H.} and Anita Deswal and Fleisher, {Lee A.} and Federico Gentile and Samuel Gidding and Goldberger, {Zachary D.} and Hlatky, {Mark A.} and John Ikonomidis and Joglar, {Jos{\'e} A.} and Laura Mauri and Susan Pressler and Barbara Riegel and Wijeysundera, {Duminda N.} and Walsh, {Mary Norine} and Shalom Jacobovitz and Oetgen, {William J.} and Elma, {Mary Anne} and Amelia Scholtz and Katherine Sheehan and Abdullah, {Abdul R.} and Naira Tahir and Warner, {John J.} and Nancy Brown and Robertson, {Rose Marie} and Whitman, {Gayle R.} and Jody Hundley",
year = "2018",
month = "6",
day = "1",
doi = "10.1161/HYP.0000000000000067",
language = "English (US)",
volume = "71",
pages = "E116--E135",
journal = "Hypertension",
issn = "0194-911X",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Systematic review for the 2017 ACC/AHA/AAPA/ABC/ ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults a report of the American College of Cardiology/American Heart Association Task Force on Clinical practice guidelines

AU - American College of Cardiology

AU - American College of Cardiology/American Heart Association

AU - Reboussin, David M.

AU - Allen, Norrina B.

AU - Griswold, Michael E.

AU - Guallar, Eliseo

AU - Hong, Yuling

AU - Lackland, Daniel T.

AU - Miller, Edgar R.

AU - Polonsky, Tamar

AU - Thompson-Paul, Angela M.

AU - Vupputuri, Suma

AU - Levine, Glenn N.

AU - O'Gara, Patrick T.

AU - Halperin, Jonathan L.

AU - Past, Immediate

AU - Al-Khatib, Sana M.

AU - Beckman, Joshua A.

AU - Birtcher, Kim K.

AU - Bozkurt, Biykem

AU - Brindis, Ralph G.

AU - Cigarroa, Joaquin E.

AU - Curtis, Lesley H.

AU - Deswal, Anita

AU - Fleisher, Lee A.

AU - Gentile, Federico

AU - Gidding, Samuel

AU - Goldberger, Zachary D.

AU - Hlatky, Mark A.

AU - Ikonomidis, John

AU - Joglar, José A.

AU - Mauri, Laura

AU - Pressler, Susan

AU - Riegel, Barbara

AU - Wijeysundera, Duminda N.

AU - Walsh, Mary Norine

AU - Jacobovitz, Shalom

AU - Oetgen, William J.

AU - Elma, Mary Anne

AU - Scholtz, Amelia

AU - Sheehan, Katherine

AU - Abdullah, Abdul R.

AU - Tahir, Naira

AU - Warner, John J.

AU - Brown, Nancy

AU - Robertson, Rose Marie

AU - Whitman, Gayle R.

AU - Hundley, Jody

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Objective-To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy? Methods-Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question. We performed analyses using traditional frequentist statistical and Bayesian approaches, including random-effects Bayesian network meta-analyses. Results-Our results suggest that: 1) There is a modest but significant improvement in systolic BP in randomized controlled trials of self-measured BP versus usual care at 6 but not 12 months, and for selected patients and their providers self-measured BP may be a helpful adjunct to routine office care. 2) systolic BP lowering to a target of <130 mm Hg may reduce the risk of several important outcomes including risk of myocardial infarction, stroke, heart failure, and major cardiovascular events. No class of medications (ie, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, calcium channel blockers, or beta blockers) was significantly better than thiazides and thiazide-like diuretics as a first-line therapy for any outcome.

AB - Objective-To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy? Methods-Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question. We performed analyses using traditional frequentist statistical and Bayesian approaches, including random-effects Bayesian network meta-analyses. Results-Our results suggest that: 1) There is a modest but significant improvement in systolic BP in randomized controlled trials of self-measured BP versus usual care at 6 but not 12 months, and for selected patients and their providers self-measured BP may be a helpful adjunct to routine office care. 2) systolic BP lowering to a target of <130 mm Hg may reduce the risk of several important outcomes including risk of myocardial infarction, stroke, heart failure, and major cardiovascular events. No class of medications (ie, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, calcium channel blockers, or beta blockers) was significantly better than thiazides and thiazide-like diuretics as a first-line therapy for any outcome.

KW - AHA Scientific Statements

KW - Antihypertensive drug class

KW - Blood pressure

KW - Cardiovascular disease

KW - Evidence Review Committee

KW - Home blood pressure monitoring

KW - Hypertension

KW - Meta-analysis

KW - Risk reduction

KW - Targets

KW - Treatment outcomes

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U2 - 10.1161/HYP.0000000000000067

DO - 10.1161/HYP.0000000000000067

M3 - Review article

VL - 71

SP - E116-E135

JO - Hypertension

JF - Hypertension

SN - 0194-911X

IS - 6

ER -