AAFP Decides to NOT Endorse HTN Guidelines

AAFP Decides to NOT Endorse HTN Guidelines

Oh snap!  Amid all the controversy about the new, stricter hypertension (HTN) guidelines put out by the American Heart Association (AHA) and the American College of Cardiology (ACC), the American Academy of Family Physicians (AAFP) has decided to NOT endorse the new hypertension guidelines.  Find out why they disagreed and what does this mean for you?

I posted this news to Instagram and Facebook previously.  But, this is the first opportunity I’ve had the time to write a post about the controversy and what this all means.

Why didn’t they agree?

Basically, the AAFP felt that the research supporting the old guidelines was more solid than the research to support the new stricter guidelines with the lower blood pressure cut-offs.  They felt that the new hypertension guidelines were based largely on one clinical trial.  In addition, harms and adverse effects from the new lower blood pressure goals are not taken into account.  There are concerns for conflicts of interest as well from the people on the panel.  The conflicts of interest are from people having drug company affiliations.  Many people on the ACC/AHA panel are in bed with the drug companies who make blood pressure medications.  See the charts below to compare and contrast the 2014 JNC8 versus the new AHA/ACC hypertension guidelines.

JNCVIII

 

New BP Guidelines 2017

 

What Does This Mean?

This news means that half of Americans who are considered hypertensive under AHA/ACC, should double-check and possibly go back to the old guidelines of >140/90 (>150/90 for greater than 60 years of age) to diagnose high blood pressure (BP).

Most of all, you should still work on lifestyle modifications as listed below.  This is true for everyone, regardless of whether you have HTN or not.

Lifestyle Modifications
Adapted from Chobanion et al.

 

Positives From AHA/ACC Guidelines

  • Stressed accurate BP measurements before diagnosis and also has suggestions to ensure accurate measurements (like ambulatory and 24 hour BP monitoring).
  • Stressed the importance of home BP monitoring using proper technique and validated devices.
    • Average of 2-3 BP readings at least 2 times a day and avoid white-coat hypertension and masked hypertension.
    • Recommend taking BP at different times of day, in different settings
  • It discussed the importance of healthy lifestyle choices to minimize hypertension risk.

Addressing Questions

Talk to your primary health care provider with any questions or concerns.

If you are a heath care provider then be ready and able to discuss the differences between and within the currently 2 hypertension guidelines.  Know the recommendations and the science behind the recommendations.  Engage patients about what they’ve heard from media outlets, friends, family and other physicians.  Teach patients the benefits of lower BP, and the associated risks; especially because the risks aren’t discussed for the AHA/ACC guidelines.

See the full article here.

 

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