Documento de la Sociedad Española de Hipertensión-Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA) sobre las guías ACC/AHA 2017 de hipertensión arterial

  1. T. Gijón-Conde 1
  2. M. Gorostidi 2
  3. M. Camafort 3
  4. M. Abad-Cardiel 4
  5. E. Martín-Rioboo 5
  6. F. Morales-Olivas 6
  7. E. Vinyoles 7
  8. P. Armario 8
  9. J.R. Banegas 9
  10. A. Coca 10
  11. A. de la Sierra 11
  12. N. Martell-Claros 4
  13. J. Redón 6
  14. L.M. Ruilope 9
  15. J. Segura 12
  1. 1 Centro de Salud Universitario Cerro del Aire, Majadahonda (Madrid)
  2. 2 Hospital Universitario Central de Asturias
    info

    Hospital Universitario Central de Asturias

    Oviedo, España

    ROR https://ror.org/03v85ar63

  3. 3 Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona
  4. 4 Hospital Clínico San Carlos, Madrid
  5. 5 Instituto Maimónides de Investigación Biomédica de Córdoba
    info

    Instituto Maimónides de Investigación Biomédica de Córdoba

    Córdoba, España

    ROR https://ror.org/00j9b6f88

  6. 6 Universitat de València
    info

    Universitat de València

    Valencia, España

    ROR https://ror.org/043nxc105

  7. 7 Centre d’Atenció Primària La Mina, Barcelona
  8. 8 Hospital Moisès Broggi Sant Joan Despi, Barcelona
  9. 9 Universidad Autónoma Madrid
  10. 10 nstitut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona
  11. 11 Hospital Mutua Terrassa
  12. 12 Hospital Universitario 12 de Octubre, Madrid
Show affiliations +
Journal:
Hipertensión y riesgo vascular

ISSN: 1889-1837

Year of publication: 2018

Volume: 35

Issue: 3

Pages: 119-129

Type: Article

DOI: 10.1016/J.HIPERT.2018.04.001 DIALNET GOOGLE SCHOLAR

More publications in: Hipertensión y riesgo vascular

Sustainable development goals

Abstract

The American College of Cardiology (ACC) and the American Heart Association (AHA) have recently published their guidelines for the prevention, detection, evaluation, and management of hypertension in adults. The most controversial issue is the classification threshold at 130/80mmHg, which will allow a large number of patients to be diagnosed as hypertensive who were previously considered normotensive. Blood pressure (BP) is considered normal (<120mmHg systolic and <80mmHg diastolic), elevated (120-129 and <80mmHg), stage 1 (130-139 or 80-89mmHg), and stage 2 (≥140 or ≥90mmHg). Out-of-office BP measurements are recommended to confirm the diagnosis of hypertension and for titration of BP-lowering medication. In management, cardiovascular risk would be determinant since those with grade 1 hypertension and an estimated 10-year risk of atherosclerotic cardiovascular disease ≥10%, and those with cardiovascular disease, chronic kidney disease and/or diabetes will require pharmacological treatment, the rest being susceptible to non-pharmacological treatment up to the 140/90mmHg threshold. These recommendations would allow patients with level 1 hypertension and high atherosclerotic cardiovascular disease to benefit from pharmacological therapies and all patients could also benefit from improved non-pharmacological therapies. However, this approach should be cautious because inadequate BP measurement and/or lack of systematic atherosclerotic cardiovascular disease calculation could lead to overestimation in diagnosing hypertension and to overtreatment. Guidelines are recommendations, not impositions, and the management of hypertension should be individualized, based on clinical decisions, preferences of the patients, and an adequate balance between benefits and risks.

Data source: Dialnet