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: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
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 (ie, 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.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Adoption of HBPM is still challenging because of barriers that involve cultural, structural and financial domains.
“Adoption of HBPM is still challenging because of barriers that involve three general domains: cultural, structural and financial [255–258].”
Cites
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · BMJ · doi:10.1136/bmj.b2700 · Cited by 17,648 · see citing works
Ettehad, D., Emdin, C. A., Kiran, A., Anderson, S. G., Callender, T., Emberson, J., Chalmers, J., Rodgers, A., & Rahimi, K. (2016) · The Lancet · doi:10.1016/s0140-6736(15)01225-8 · Cited by 3,755 · see citing works
Law, M. R., Morris, J. K., & Wald, N. J. (2009) · BMJ · doi:10.1136/bmj.b1665 · Cited by 2,775 · see citing works
Dias, S., Sutton, A. J., Ades, A. E., & Welton, N. J. (2013) · Medical Decision Making · doi:10.1177/0272989x12458724 · Cited by 1,207 · see citing works
Xie, X., Atkins, E., Lv, J., Bennett, A., Neal, B., Ninomiya, T., Woodward, M., MacMahon, S., Turnbull, F., Hillis, G. S., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(15)00805-3 · Cited by 980 · see citing works
Margolis, K. L., Asche, S. E., Bergdall, A. R., Dehmer, S. P., Groen, S. E., Kadrmas, H. M., Kerby, T. J., Klotzle, K. J., Maciosek, M. V., Michels, R. D., et al. (2013) · JAMA · doi:10.1001/jama.2013.6549 · Cited by 591 · see citing works
Thomopoulos, C., Parati, G., & Zanchetti, A. (2016) · Journal of Hypertension · doi:10.1097/hjh.0000000000000881 · Cited by 298 · cited 2× · see citing works
“Similar to our findings, CCBs have previously been found to be associated with higher risk of heart failure and beta blockers with a higher risk of stroke.(37,83,85) Understanding the benefits of one antihypertensive drug class versus another is of critical importance in determining which first-line medication should…”
ResultBliziotis, I. A., Destounis, A., & Stergiou, G. S. (2012) · Journal of Hypertension · doi:10.1097/hjh.0b013e3283531eaf · Cited by 261 · see citing works
on behalf of Hypertension Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure (HOMED-BP) investigators, Asayama, K., Ohkubo, T., Metoki, H., Obara, T., Inoue, R., Kikuya, M., Thijs, L., Staessen, J. A., & Imai, Y. (2012) · Hypertension Research · doi:10.1038/hr.2012.125 · Cited by 186 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association
Virani, S. S., Alonso, A., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Delling, F. N., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000757 · Cited by 9,175 · see citing works
Self-citationHeart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association
Benjamin, E. J., Muntner, P., Alonso, A., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Das, S. R., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000659 · Cited by 9,036 · see citing works
Self-citationWhelton, 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) · Hypertension · doi:10.1161/hyp.0000000000000065 · Cited by 7,391 · see citing works
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) · Circulation · doi:10.1161/cir.0000000000000678 · Cited by 4,536 · see citing works
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) · Hypertension · doi:10.1161/hyp.0000000000000066 · Cited by 4,347 · see citing works
2024 ESC Guidelines for the management of elevated blood pressure and hypertension
McEvoy, J. W., McCarthy, C. P., Bruno, R. M., Brouwers, S., Canavan, M. D., Ceconi, C., Christodorescu, R. M., Daskalopoulou, S. S., Ferro, C. J., Gerdts, E., et al. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehae178 · Cited by 2,298 · see citing works
Jones, D. W., Ferdinand, K. C., Taler, S. J., Johnson, H. M., Shimbo, D., Abdalla, M., Altieri, M. M., Bansal, N., Bello, N. A., Bress, A. P., et al. (2025) · JACC · doi:10.1016/j.jacc.2025.05.007 · Cited by 280 · see citing works
Parati, G., Stergiou, G. S., Bilo, G., Kollias, A., Pengo, M., Ochoa, J. E., Agarwal, R., Asayama, K., Asmar, R., Burnier, M., et al. (2021) · Journal of Hypertension · doi:10.1097/hjh.0000000000002922 · Cited by 178 · see citing works
- 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.
- ORCID
- Venue
- Hypertension
- Published
- 2018-06
- Volume
- 71
- Issue
- 6
- Pages
- e116-e135
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W4236540794
- Cited by
- 175
- References
- 10
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 24 · 2023: 18 · 2022: 12 · 2021: 22 · 2020: 27 · 2019: 23 · 2018: 25 · 2017: 2
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Update notices
- correction (2018-05-09)
- Open access
- bronze
- doi.org
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- AstraZeneca
- Sanofi
- American College of Cardiology Foundation
- Kaiser Permanente
- Johns Hopkins University
- University of South Carolina
- Public Health Agency of Canada
- Centers for Disease Control and Prevention
- Office of Science
- Johns Hopkins Bloomberg School of Public Health
- National Center for Chronic Disease Prevention and Health Promotion
- 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
- 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, Blood Pressure, Cardiology, Humans, Hypertension, United States, Practice Guidelines as Topic
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 ›
Are you an author, or do you see a problem with this page? Request a review
