International Journal of Cardiology. Hypertension (Dec 2020)

Impact of the 2017 ACC/AHA guidelines on the prevalence of hypertension among Indian adults: Results from a cross-sectional survey

  • Kartik Gupta,
  • Sivasubramanian Ramakrishnan,
  • Geevar Zachariah,
  • J. Shivkumar Rao,
  • P.P. Mohanan,
  • K. Venugopal,
  • Santosh Sateesh,
  • Rishi Sethi,
  • Dharmendra Jain,
  • Neil Bardolei,
  • Kalaivani Mani,
  • Tanya Singh Kakar,
  • Vardhmaan Jain,
  • Prakash Gupta,
  • Rajeev Gupta,
  • Sandeep Bansal,
  • Ranjit K. Nath,
  • Sanjay Tyagi,
  • G.S. Wander,
  • Satish Gupta,
  • Subroto Mandal,
  • Nagendra Boopathy Senguttuvan,
  • Geetha Subramanyam,
  • Debabatra Roy,
  • Sibananda Datta,
  • Kajal Ganguly,
  • S.N. Routray,
  • S.S. Mishra,
  • B.P. Singh,
  • B.B. Bharti,
  • Mrinal Kanti Das,
  • P.K. Deb,
  • Prakash Deedwania,
  • Ashok Seth,
  • J. Shivkumar Rao,
  • B.P. Singh,
  • B.B. Bharti,
  • A.K. Sinha,
  • Kartik Gupta,
  • Sivasubramanian Ramakrishnan,
  • Sudha Bhushan,
  • Sunil K. Verma,
  • Balram Bhargava,
  • Ambuj Roy,
  • Sandeep Bansal,
  • Sanjay Sood,
  • H.S. Isser,
  • Neeraj Pandit,
  • Ranjit K. Nath,
  • Sanjay Tyagi,
  • Vijay Trehan,
  • Mohit D. Gupta,
  • M.P. Girish,
  • Ramandeep Ahuja,
  • S.C. Manchanda,
  • Arun Mohanty,
  • Peeyush Jain,
  • Sameer Shrivastava,
  • I.P.S. Kalra,
  • B.S. Sarang,
  • H.S. Ratti,
  • G. Bala Sahib,
  • Rakesh Gupta,
  • S K Agarwal Amit,
  • K.C. Goswami,
  • V.K. Bahl,
  • H.K. Chopra,
  • Ashok Seth,
  • Geevar Zachariah,
  • P.P. Mohanan,
  • K. Venugopal,
  • George Koshy,
  • Tiny Nair,
  • N. Shyam,
  • Anil Roby,
  • Raju George,
  • Sudhaya Kumar,
  • Abdul Kader,
  • Mathew Abraham,
  • Sunitha Viswanathan,
  • A. Jabir,
  • Jaideep Menon,
  • Govindan Unni,
  • Cibu Mathew,
  • P.B. Jayagopal,
  • Sajeev,
  • P.K. Ashokan,
  • Asharaf,
  • Subroto Mandal,
  • A.K. Pancholia,
  • Neil Bardolei,
  • A.K. Gupta,
  • Neil Bardolei,
  • Rupam Das,
  • Dinesh Aggarwal,
  • Amit Malviya,
  • S.N. Routray,
  • S.S. Mishra,
  • Syed Manzor Ali,
  • Parag Barward,
  • Navreet Singh,
  • Yashbir S. Tomar,
  • Davinder Chaddha,
  • Sameer Dani,
  • Chirayu Vyas,
  • Kinjal Bhatt,
  • Shrenik Doshi,
  • G.S. Wander,
  • Satish Gupta,
  • Chandra Bhan Meena,
  • Santosh Sateesh,
  • Nagendra Boopathy Senguttuvan,
  • Geetha Subramanyam,
  • Subramanyam,
  • Ajit Mullasari Muruganandam,
  • Rishi Sethi,
  • Varun Narain,
  • R.K. Saran,
  • Dharmendra Jain,
  • Praveen Jain,
  • Sudeep Kumar,
  • P.K. Goel,
  • Debabatra Roy,
  • Sibananda Datta,
  • Kajal Ganguly,
  • M.K. Das,
  • Soumitra Kumar,
  • Sarat Chandra,
  • Amal Banerjee,
  • Santanu Guha,
  • P.K. Deb

Journal volume & issue
Vol. 7
p. 100055

Abstract

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Background: The impact of the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for diagnosis and management of hypertension on the prevalence of hypertension in India is unknown. Methods: We analyzed data from the Cardiac Prevent 2015 survey to estimate the change in the prevalence of hypertension. The JNC8 guidelines defined hypertension as a systolic blood pressure of ≥140 ​mmHg or diastolic blood pressure of ≥90 ​mmHg. The 2017 ACC/AHA guidelines define hypertension as a systolic blood pressure of ≥130 ​mmHg or diastolic blood pressure of ≥80 ​mmHg. We standardized the prevalence as per the 2011 census population of India. We also calculated the prevalence as per the World Health Organization (WHO) World Standard Population (2000–2025). Results: Among 180,335 participants (33.2% women), the mean age was 40.6 ​± ​14.9 years (41.1 ​± ​15.0 and 39.7 ​± ​14.7 years in men and women, respectively). Among them, 8,898 (4.9%), 99,791 (55.3%), 35,694 (11.9%), 23,084 (12.8%), 9,989 (5.5%) and 2,878 (1.6%) participants belonged to age group 18–19, 20–44, 45–54, 55–64, 65–74 and ​≥ ​75 years respectively. The prevalence of hypertension according to the JNC8 and 2017 ACC/AHA guidelines was 29.7% and 63.8%, respectively- an increase of 115%. With the 2011 census population of India, this suggests that currently, 486 million Indian adults have hypertension according to the 2017 ACC/AHA guidelines, an addition of 260 million as compared to the JNC8 guidelines. Conclusion: According to the 2017 ACC/AHA guidelines, 3 in every 5 Indian adults have hypertension.

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