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Systematic Review for the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults
Open accessAbstract
Objective To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy? Methods Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question. We performed analyses using traditional frequentist statistical and Bayesian approaches, including random-effects Bayesian network meta-analyses. Results Our results suggest that: 1) There is a modest but significant improvement in systolic BP in randomized controlled trials of self-measured BP versus usual care at 6 but not 12 months, and for selected patients and their providers self-measured BP may be a helpful adjunct to routine office care. 2) systolic BP lowering to a target of <130 mm Hg may reduce the risk of several important outcomes including risk of myocardial infarction, stroke, heart failure, and major cardiovascular events. No class of medications (i.e., angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, calcium channel blockers, or beta blockers) was significantly better than thiazides and thiazide-like diuretics as a first-line therapy for any outcome.
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Davis, E. M., Appel, L. J., Wang, X., Greene, T., Astor, B. C., Rahman, M., Toto, R. D., Lipkowitz, M. S., Pogue, V. A., & Wright, J. T. (2011) · Hypertension · doi:10.1161/hypertensionaha.111.169367 · Cited by 46
Two Self-management Interventions to Improve Hypertension Control
Bosworth, H. B., Olsen, M. K., Grubber, J. M., Neary, A. M., Orr, M., Powers, B. J., Adams, M. B., Svetkey, L. P., Reed, S. D., Li, Y., et al. (2020) · PubMed Central · doi:10.1059/0003-4819-151-10-200911170-00148 · Cited by 46
Home blood pressure monitoring for mild hypertensives.
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Valsartan in Elderly Isolated Systolic Hypertension (VALISH) Study: Rationale and Design
Ogihara, T., Saruta, T., Matsuoka, H., Shimamoto, K., Fujita, T., Shimada, K., Imai, Y., & NISHIGAKI, M. (2004) · Hypertension Research · doi:10.1291/hypres.27.657 · Cited by 37
Hosseininasab, M., Jahangard‐Rafsanjani, Z., Mohagheghi, A., Sarayani, A., Rashidian, A., Javadi, M. R., Ahmadvand, A., Hadjibabaie, M., & Gholami, K. (2014) · American Journal of Hypertension · doi:10.1093/ajh/hpu062 · Cited by 33
Calcium channel blockers versus other classes of drugs for hypertension
Zhou, M., Chen, N., Yang, M., Guo, J., Zhu, C., Yang, J., Wang, Y., Yang, X., & He, L. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003654.pub3 · Cited by 16
Varis, J., & Kantola, I. M. (2010) · Blood Pressure · doi:10.3109/08037051003718457 · Cited by 14
Improving Adherence With Amlodipine/Atorvastatin Therapy: IMPACT Study
Oliver, S., Jones, J., Leonard, D., Crabbe, A., & Delkhah, Y. (2011) · Journal of Clinical Hypertension · doi:10.1111/j.1751-7176.2011.00478.x · Cited by 11
Flagged first, then by citations
1 of the 100 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- 2010, Methodology Manual and Policies From the ACCF/AHA Task Force on Practice Guidelines, American College of Cardiology and American Heart Association
- Viechtbauer, 2010, Conducting a meta-analysis in R with the metafor package, J Statistical Software, 36
Cited by
Sorted by citations
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.11.006 · Cited by 6,616
(2019) · doi:10.1161/cir.0000000000000677 · Cited by 4,501
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., et al. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2019.03.010 · Cited by 1,896
Firth, J., Siddiqi, N., Koyanagi, A., Siskind, D., Rosenbaum, S., Galletly, C., Allan, S., Caneo, C., Carney, R., Carvalho, A. F., et al. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30132-4 · Cited by 1,531
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Himmelfarb, C. D., DePalma, S. M., Gidding, S. S., Jamerson, K., Jones, D. W., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.11.005 · Cited by 947
Metadata
- Authors
- Reboussin, D. M., Allen, N. B., Griswold, M. E., Guallar, E., Hong, Y., Lackland, D. T., Miller, E. (. R., Polonsky, T., Thompson-Paul, A. M., & Vupputuri, S.
- Affiliations
- Centers for Disease Control and Prevention (US)
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2018-05
- Volume
- 71
- Issue
- 19
- Pages
- 2176-2198
- ISSN
- 0735-1097 (ISSN-L)
- PMC
- PMC8654280
- OpenAlex
- W3149811656
- Cited by
- 221
- References
- 100
- Citations by year
- 2026: 2 · 2025: 15 · 2024: 17 · 2023: 13 · 2022: 23 · 2021: 29 · 2020: 42 · 2019: 53 · 2018: 23
- FWCI
- 4.70
- Type
- journal article
- Language
- en
- Update notices
- erratum (2018-05-15)
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Keywords
- hypertension, self-measured blood pressure, office blood pressure measurement, antihypertensive therapy, blood pressure targets, first-line antihypertensive drugs, thiazide-like diuretics, ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, beta-blockers, cardiovascular outcomes, blood pressure control
- MeSH terms
- Adult, American Heart Association, Antihypertensive Agents, Cardiology, Humans, Hypertension, United States, Practice Guidelines as Topic, Disease Management, Advisory Committees, Research Report
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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