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Assessing the Impact of Intensified Hypertension (HTN) Treatment Guidelines: A Single Center Experience

Introduction: Hypertension (HTN) is an independent risk factor for heart disease, stroke, and premature death. In 2017 there was a shift in the definition of HTN by the American College of Cardiology (ACC), as well as the American Heart Association (ACC/AHA), resulting in lower blood pressure (BP) r...

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Autores principales: Naqvi, Amir, Zughaib, Marc T, Freeman, David, Gupta, Tanuj, Leung, Emmanuel, Zughaib, Marcel E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9851089/
https://www.ncbi.nlm.nih.gov/pubmed/36686098
http://dx.doi.org/10.7759/cureus.32734
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author Naqvi, Amir
Zughaib, Marc T
Freeman, David
Gupta, Tanuj
Leung, Emmanuel
Zughaib, Marcel E
author_facet Naqvi, Amir
Zughaib, Marc T
Freeman, David
Gupta, Tanuj
Leung, Emmanuel
Zughaib, Marcel E
author_sort Naqvi, Amir
collection PubMed
description Introduction: Hypertension (HTN) is an independent risk factor for heart disease, stroke, and premature death. In 2017 there was a shift in the definition of HTN by the American College of Cardiology (ACC), as well as the American Heart Association (ACC/AHA), resulting in lower blood pressure (BP) readings meeting criteria for diagnosis. Our study aimed to explore the impact the change had on a single cardiology practice’s management of patients with HTN. Methods: We performed a retrospective chart review of a single cardiology practice. We separated the time into two categories: 12 months before and 12 months after the reclassification of HTN categories in November 2017. A paired t-test analysis was done comparing averaged blood pressures (BPs) in each of the two time periods, as well as the number of medications in each time period and several subgroup analyses. Results: A total of 441 patients were included in the final analysis. Patients were prescribed an average of 2.61 ± 1.20 medications at baseline, and 2.74 ± 1.22 medications post-reclassification (p < 0.0001). There was an average of 0.82 ± 1.28 medication changes per patient. The overall average BP was 133.7 ± 14.1/76.4 ± 9.5 at baseline, and 131.3 ± 13.1/76.7 ± 7.7 after the recategorization [Δ -2.41 (95% CI 1.18-3.63)/0.269 (95% CI -0.29 to 0.459); p<0.0001 for systolic blood pressure (SBP), p=0.467 for diastolic blood pressure (DBP)]. Conclusion: The change in definition of HTN significantly impacted this single cardiology practice. There was a statistically significant increase in antihypertensive medications prescribed with an expected decrease in BP observed in this study.
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spelling pubmed-98510892023-01-19 Assessing the Impact of Intensified Hypertension (HTN) Treatment Guidelines: A Single Center Experience Naqvi, Amir Zughaib, Marc T Freeman, David Gupta, Tanuj Leung, Emmanuel Zughaib, Marcel E Cureus Cardiology Introduction: Hypertension (HTN) is an independent risk factor for heart disease, stroke, and premature death. In 2017 there was a shift in the definition of HTN by the American College of Cardiology (ACC), as well as the American Heart Association (ACC/AHA), resulting in lower blood pressure (BP) readings meeting criteria for diagnosis. Our study aimed to explore the impact the change had on a single cardiology practice’s management of patients with HTN. Methods: We performed a retrospective chart review of a single cardiology practice. We separated the time into two categories: 12 months before and 12 months after the reclassification of HTN categories in November 2017. A paired t-test analysis was done comparing averaged blood pressures (BPs) in each of the two time periods, as well as the number of medications in each time period and several subgroup analyses. Results: A total of 441 patients were included in the final analysis. Patients were prescribed an average of 2.61 ± 1.20 medications at baseline, and 2.74 ± 1.22 medications post-reclassification (p < 0.0001). There was an average of 0.82 ± 1.28 medication changes per patient. The overall average BP was 133.7 ± 14.1/76.4 ± 9.5 at baseline, and 131.3 ± 13.1/76.7 ± 7.7 after the recategorization [Δ -2.41 (95% CI 1.18-3.63)/0.269 (95% CI -0.29 to 0.459); p<0.0001 for systolic blood pressure (SBP), p=0.467 for diastolic blood pressure (DBP)]. Conclusion: The change in definition of HTN significantly impacted this single cardiology practice. There was a statistically significant increase in antihypertensive medications prescribed with an expected decrease in BP observed in this study. Cureus 2022-12-20 /pmc/articles/PMC9851089/ /pubmed/36686098 http://dx.doi.org/10.7759/cureus.32734 Text en Copyright © 2022, Naqvi et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiology
Naqvi, Amir
Zughaib, Marc T
Freeman, David
Gupta, Tanuj
Leung, Emmanuel
Zughaib, Marcel E
Assessing the Impact of Intensified Hypertension (HTN) Treatment Guidelines: A Single Center Experience
title Assessing the Impact of Intensified Hypertension (HTN) Treatment Guidelines: A Single Center Experience
title_full Assessing the Impact of Intensified Hypertension (HTN) Treatment Guidelines: A Single Center Experience
title_fullStr Assessing the Impact of Intensified Hypertension (HTN) Treatment Guidelines: A Single Center Experience
title_full_unstemmed Assessing the Impact of Intensified Hypertension (HTN) Treatment Guidelines: A Single Center Experience
title_short Assessing the Impact of Intensified Hypertension (HTN) Treatment Guidelines: A Single Center Experience
title_sort assessing the impact of intensified hypertension (htn) treatment guidelines: a single center experience
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9851089/
https://www.ncbi.nlm.nih.gov/pubmed/36686098
http://dx.doi.org/10.7759/cureus.32734
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