JAMAevidence The Rational Clinical Examination
Does This Adult Patient Have Hypertension? Interview With Dr Anthony Joseph Viera
Jan 6, 2022
Dr. Anthony Joseph Viera, a physician specializing in public health and hypertension, delves into the complexities of hypertension diagnosis. He discusses the updated thresholds for hypertension and the influence of age on prevalence rates. The conversation highlights challenges in accurately measuring blood pressure in clinical settings and compares traditional methods with 24-hour monitoring. Viera emphasizes the importance of home monitoring and explains masked hypertension, stressing the need for comprehensive out-of-office measurements to manage this hidden condition effectively.
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Quick takeaways
- Recent guidelines redefine hypertension, impacting nearly 47% of U.S. adults and highlighting age-related prevalence increases.
- Accurate hypertension diagnosis benefits from combining home monitoring with office readings, addressing challenges in traditional measurement methods.
Deep dives
Prevalence and Definition of Hypertension
Hypertension prevalence varies based on age and defined thresholds. The American College of Cardiology and American Heart Association guidelines from 2017 redefine hypertension as an office blood pressure greater than 130/80 mm Hg, adjusting the previous high threshold of 140/90 mm Hg. This shift results in around 47% of adults in the U.S. being classified as having hypertension, with prevalence increasing significantly with age; 76% of those aged 65 and older are affected. The data indicates that reaching an old age without developing hypertension is quite uncommon.
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