Comparison of the JNC7 and 2017 American College of Cardiology/American Heart Association Guidelines for the Management of Hypertension in Koreans

Analysis of Two Independent Nationwide Population-Based Studies

Bibliographic Data

ID15468326
AuthorsWon‐Jun Choi (0000-0002-8233-9272, Yonsei University), Hye Sun Lee (0000-0003-1392-3376, Yonsei University), Jung Hwa Hong (National Health Insurance Service Ilsan Hospital), Hyuk‐Jae Chang (0000-0002-6139-7545, Yonsei University Health System, corresponding author), Ji‐won Lee (0000-0002-2666-4249, Yonsei University, corresponding author)
Year2019
Volume16
Issue24
Pages5134-5134
Publication date2019-12-16
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph16245134
PMID31888171
OpenAlexW2996201361
LanguageEN
References cited19

The optimal blood pressure (BP) guidelines in Asian populations have not been determined. We compared all-cause and cardiovascular mortality based on the Joint National Committee 7 (JNC7) and 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines. The National Health Insurance System-National Health Screening Cohort (NHIS-HEALS) and Korea National Health and Nutrition Examination Survey (KNHANES) were utilized. BPs were classified into three groups according to each guideline, and survival rates were analyzed with Kaplan-Meier curves and log-rank tests. Hazard ratios (HRs) were calculated using multivariable cox regression analyses, and the discriminatory ability for clinical outcomes was assessed by Harrell's C-indexes. The JNC7 guidelines demonstrated a linear association between BP levels and survival outcomes. Adjusted HRs from the JNC7 guidelines differentiated the hypertension group (≥140/90) from the pre (130/80-139/89) and normal (<130 and <80) BP groups in clinical outcomes. In contrast, the 2017 ACC/AHA guidelines showed inconsistent survival outcomes according to BP classification (normal: <120 and <80, elevated: 120-129, and <80, and HTN: ≥130/80). According to Harrell's C-indexes, the JNC7 guidelines had greater discrimination ability in survival outcomes in the NHIS-HEALS dataset. Our results suggest that the JNC7 guidelines are more appropriate than the 2017 ACC/AHA guidelines in Korean populations

Blood pressure · Cohort · Confidence interval · Environmental health · Family medicine · Guideline · Hazard ratio · Korean population · National Health and Nutrition Examination Survey · National health insurance · Pathology · Population · Proportional hazards model · Blood Pressure and Hypertension Studies · Demography · Medicine · Nutritional Studies and Diet · Sodium Intake and Health · Internal Medicine

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