Prevalence, awareness, treatment, and control of hypertension based on ACC/AHA versus JNC7 guidelines in the PERSIAN cohort study

Authors

Sadaf Sepanlou # 1, Farid Najafi # 2, Hossein Poustchi 3, Mahboubeh Parsaeian 4, Ali Ahmadi 5, Mohammadhossein Somi 6, Farhad Moradpour 7, Reza Alizadeh-Navaei 8, Ali Gohari 9, Bijan Zamani 10, Ali Esmaeilinadimi 11, Abbas Rezaianzadeh 12, Fariborz Mansour-Ghanaei 13, Ehsan Bahramali 14, Alireza Ansari-Moghaddam 15, Behrooz Hamzeh 2, Elham Zanganeh Yousefabadi 16, Mohammad Javad Zare Sakhvidi 17, Iraj Mohebbi 18, Mohammad Reza Fattahi 19, Azim Nejatizadeh 20, Hossein Marioryad 21, Nazgol Motamed-Gorji 3, Farzin Roozafzai 3, Sareh Eghtesad 3, Zahra Mohammadi 3, Amaneh Shayanrad 3, Maryam Sharafkhah 3, Arash Etemadi 22, Farin Kamangar 23, Stephen P Juraschek 24, Reza Malekzadeh 25

    • 1Digestive Disease Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
    • 2Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
    • 3Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
    • 4Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
    • 5Department of Epidemiology and Biostatistics, Modeling in Health Research Center, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.
    • 6Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    • 7Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
    • 8Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
    • 9Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.
    • 10Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
    • 11Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
    • 12Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
    • 13Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
    • 14Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
    • 15Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
    • 16Department of Internal Medicine, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
    • 17Occupational Health Research Centre, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
    • 18Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran.
    • 19Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
    • 20Molecular Medicine Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
    • 21Yasuj University of Medical Sciences, Yasuj, Iran.
    • 22Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
    • 23Department of Biology, School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, USA.
    • 24Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
    • 25Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, North Kargar Ave., Tehran, 14117-13135, Iran. malek@tums.ac.ir.
    #Contributed equally.

Abstract

In this cross-sectional population-based study, we used the baseline data of the Prospective Epidemiologic Research Studies in IrAN cohort study collected in Iran from 2014 to 2020. The main outcomes were the prevalence of hypertension and proportion of awareness, treatment, and control based on the 2017 ACC/AHA guideline compared to the seventh report of the Joint National Committee (JNC7). Of the total of 163,770 participants, aged 35-70 years, 55.2% were female. The sex-age standardized prevalence of hypertension was 22.3% (95% CI 20.6, 24.1) based on the JNC7 guideline and 36.5% (31.1, 41.8) based on the ACC/AHA guideline. A total of 24,312 participants [14.1% (10.1, 18.1)] were newly diagnosed based on the ACC/AHA guideline. Compared to adults diagnosed with hypertension based on the JNC7 guideline, the newly diagnosed participants were mainly young literate males who had low levels of risk factors and were free from conventional comorbidities of hypertension. About 30.7% (25.9, 35.4) of them (4.3% of the entire population) were eligible for pharmacologic intervention based on the ACC/AHA guideline. Implementation of the new guideline may impose additional burden on health systems. However, early detection and management of elevated blood pressure may reduce the ultimate burden of hypertension in Iran.

How to Cite

Sepanlou S, Najafi F, Poustchi H, Parsaeian M, Ahmadi A, Somi M, Moradpour F, Alizadeh-Navaei R, Gohari A, Zamani B, Esmaeilinadimi A, Rezaianzadeh A, Mansour-Ghanaei F, Bahramali E, Ansari-Moghaddam A, Hamzeh B, Zanganeh Yousefabadi E, Zare Sakhvidi MJ, Mohebbi I, Fattahi MR, Nejatizadeh A, Marioryad H, Motamed-Gorji N, Roozafzai F, Eghtesad S, Mohammadi Z, Shayanrad A, Sharafkhah M, Etemadi A, Kamangar F, Juraschek SP, Malekzadeh R. Prevalence, awareness, treatment, and control of hypertension based on ACC/AHA versus JNC7 guidelines in the PERSIAN cohort study. Sci Rep. 2022 Mar 8;12(1):4057. doi: 10.1038/s41598-022-07896-9. PMID: 35260709; PMCID: PMC8904851.

Metrics

Prevalence, awareness, treatment, and control of hypertension based on ACC/AHA versus JNC7 guidelines in the PERSIAN cohort study