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Comparison of the association of masked hypertension defined by the 2017 ACC/AHA BP guideline versus the JNC7 guideline with left ventricular hypertrophy.


ABSTRACT:

Background

Compared with the Seventh Report of the Joint National Committee (JNC7), the 2017 American College of Cardiology/American Heart Association (ACC/AHA) blood pressure (BP) guideline uses lower BP thresholds to define hypertension and BP control.

Methods

We pooled data from five US-based studies to compare the association of masked hypertension (MHT) and masked uncontrolled hypertension, defined using the 2017 ACC/AHA guideline ( n  = 1653 without high office BP; <130/80 mmHg) versus the JNC7 guideline ( n  = 2451 without high office BP; <140/90 mmHg), with left ventricular hypertrophy (LVH). MHT and masked uncontrolled hypertension were defined using office BP and awake BP alone and awake, asleep, or 24-h BP. LVH was assessed by echocardiography.

Results

Among participants without high office BP not taking antihypertensive medication, the prevalence of MHT defined by the JNC7 guideline and the 2017 ACC/AHA BP guideline was 25.0 and 33.5% using awake BP only and 37.1 and 52.0% when using awake, asleep, or 24-h BP. The adjusted prevalence ratios for LVH associated with MHT versus sustained normotension defined by the JNC7 and 2017 ACC/AHA BP guidelines were 1.72 [95% confidence interval (CI): 1.12-2.64] and 1.56 (95% CI: 0.97-2.51), respectively, when using awake BP only and 2.16 (95% CI: 1.36-3.44) and 1.03 (95% CI: 0.58-1.82), respectively, when using awake, asleep or 24-h BP. There was no evidence that masked uncontrolled hypertension was associated with LVH when defined using the BP thresholds in either the JNC7 or the 2017 ACC/AHA BP guideline.

Conclusion

The association of MHT with LVH may depend on the BP thresholds used.

SUBMITTER: Poudel B 

PROVIDER: S-EPMC9415199 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Comparison of the association of masked hypertension defined by the 2017 ACC/AHA BP guideline versus the JNC7 guideline with left ventricular hypertrophy.

Poudel Bharat B   Viera Anthony J AJ   Shimbo Daichi D   Schwartz Joseph E JE   Shikany James M JM   Sakhuja Swati S   Lloyd-Jones Donald M DM   Muntner Paul P   Yano Yuichiro Y  

Journal of hypertension 20220705 8


<h4>Background</h4>Compared with the Seventh Report of the Joint National Committee (JNC7), the 2017 American College of Cardiology/American Heart Association (ACC/AHA) blood pressure (BP) guideline uses lower BP thresholds to define hypertension and BP control.<h4>Methods</h4>We pooled data from five US-based studies to compare the association of masked hypertension (MHT) and masked uncontrolled hypertension, defined using the 2017 ACC/AHA guideline ( n  = 1653 without high office BP; <130/80 m  ...[more]

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