title: Proportion of US adults potentially affected by the 2014 hypertension guideline.
abstract: OBJECTIVE
  The new 2014 blood pressure (BP) guideline released by the panel members appointed to the Eighth Joint National Committee (JNC 8; 2014 BP guideline) proposed less restrictive BP targets for adults aged 60 years or older and for those with diabetes and chronic kidney disease.
  
  
  OBJECTIVE
  To estimate the proportion of US adults potentially affected by recent changes in recommendations for management of hypertension.
  
  
  METHODS
  Cross-sectional, nationally representative survey.
  
  
  METHODS
  Using data from the National Health and Nutrition Examination Survey between 2005 and 2010 (n = 16,372), we evaluated hypertension control and treatment recommendations for US adults.
  
  
  METHODS
  Proportion of adults estimated to meet guideline-based BP targets under the 2014 BP guideline and under the previous seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guideline.
  
  
  RESULTS
  The proportion of younger adults (18-59 years) with treatment-eligible hypertension under the JNC 7 guideline was 20.3% (95% CI, 19.1%-21.4%) and decreased to 19.2% (95% CI, 18.1%-20.4%) under the 2014 BP guideline. Larger declines were observed among older adults (≥60 years), decreasing from 68.9% (95% CI, 66.9%-70.8%) under JNC 7 to 61.2% (95% CI, 59.3%-63.0%) under the 2014 BP guideline. The proportion of adults with treatment-eligible hypertension who met BP goals increased slightly for younger adults, from 41.2% (95% CI, 38.1%-44.3%) under JNC 7 to 47.5% (95% CI, 44.4%-50.6%) under the 2014 BP guideline, and more substantially for older adults, from 40.0% (95% CI, 37.8%-42.3%) under JNC 7 to 65.8% (95% CI, 63.7%-67.9%) under the 2014 BP guideline. Overall, 1.6% (95% CI, 1.3%-1.9%) of US adults aged 18-59 years and 27.6% (95% CI, 25.9%-29.3%) of adults aged 60 years or older were receiving BP-lowering medication and meeting more stringent JNC 7 targets. These patients may be eligible for less stringent or no BP therapy with the 2014 BP guideline.
  
  
  CONCLUSIONS
  Compared with the JNC 7 guideline, the 2014 BP guideline from the panel members appointed to the JNC 8 was associated with a reduction in the proportion of US adults recommended for hypertension treatment and a substantial increase in the proportion of adults considered to have achieved goal BP, primarily in older adults.
authors.affiliation: Division of Cardiology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Navar-Boggan
authors.affiliation: DCRI, Biostatistics and Bioinformatics, Duke University, Durham, North Carolina.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Pencina
authors.affiliation: KenAnCo Biostatistics, San Antonio, Texas.
authors.forename: Ken
authors.initials: K
authors.lastname: Williams
authors.affiliation: Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Allan D
authors.initials: AD
authors.lastname: Sniderman
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina6Associate Editor, JAMA.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D048909:Diabetes Complications; D019468:Disease Management; D005260:Female; D006801:Humans; D006973:Hypertension / Q000145:classification* / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D051436:Renal Insufficiency, Chronic / Q000150:complications; D014481:United States / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents