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Re-Classifying Hypertension in the Venezuelan EVESCAM Database Using 2017 AHA/ACC Criteria: High Prevalence, Poor Control, and Urgent Call for Action

By May 1, 2019September 24th, 2020No Comments


Annals of Global Health

Juan González-Rivas 1 ,
Jeffrey Mechanick 2 ,
Maritza Duran 3 ,
Eunice Ugel 4 ,
María Marulanda 5 ,
Ramfis Nieto-Martínez 6

Background: In 2017 the American Heart Association (AHA)/American College of
Cardiology (ACC) changed the criteria to define hypertension (HTN).
Objective: To re-analyze Venezuelan data to update HTN prevalence rates and estimate
the number of adults with uncontrolled blood pressure (BP) using AHA/ACC
Methods: The EVESCAM was a national population-based, cross-sectional, randomized
cluster sampling study, which assessed 3,420 adults from July 2014 to
January 2017, with a response rate of 77.3%. The mean of two BP
measurements was obtained using a standard oscillometric device protocol.
HTN was defined using both 2017 AHA/ACC guideline (BP ≥ 130/80 mmHg) and
JNC7 (BP ≥ 140/90 mmHg) criteria.
Findings: The crude prevalence of HTN using 2017 AHA/ACC guideline criteria was
60.4%, 13% higher than with the JNC7 criteria. The age-standardized
prevalence was 55.4% in men and 49.0% in women (p < 0.001), 17.5% and 12.7% higher, respectively, compared with the JNC7 criteria. In subjects without self-reported HTN, the age-standardized prevalence of HTN was 43.4% in men and 32.3% in women, of whom, 22.9% and 19.2% were between 130-139/80-89 mmHg, respectively. In those with self-reported HTN, the prevalence of uncontrolled BP (≥130/80 mmHg) on antihypertensive medication was 66.8% in men and 65.8% in women. The total estimated number of subjects with HTN in Venezuela increased to 11 million, and only about 1.8 million are controlled. Conclusion: Using the new 2017 AHA/ACC guideline, the prevalence of HTN in Venezuela is approximately half of the adult population and associated with relatively poor BP control.


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