Potential effects of 2017 ACC/AHA hypertension guideline on the prevalence of hypertension among population aged 40-79 with different glucose metabolism in Guiyang city

Abstract

Objective To discuss hypertension situations of 40-79 years old residents with different glucose metabolic status in Guiyang urban area under the new hypertension diagnostic criteria proposed by American College of Cardiology/American Heart Association (ACC/AHA) in 2017 and provide a clue for diagnostic criteria and treatment strategy of hypertension. Methods 10 140 residents in 40-79 years old in Risk Evaluation of cAncers in Chinese diabeTic Individuals: a IONgitudinal (REACTION) Study Research Guiyang Sub-center were conducted retrospective analysis. According to medical history of diabetes and oral glucose tolerance test results, these residents were divided into normal glucose group, impaired fasting glucose(IFG) group, impaired glucose tolerance (IGT) group, IFG+ IGF group, previous diagnostic diabetes group and newly diagnosed diabetes group. Hypertension situation of residents with different glucose metabolic status under the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), and Hypertension Guide of ACC/AHA in 2017 were calculated. Results Under JNC 7 criteria, hypertension′s standardized prevalence rate of normal blood glucose people, prediabetes patients, and diabetes patients in 40-79 years old respectively reached 8.19%, 9.57%, and 8.19%. Under ACC/AHA 2017 criteria, hypertension′s standardized prevalence rate respectively reached 20.27%, 16.35%, and 11.59%. By contrast, the most obvious increase of hypertension′s prevalence rate was in the normal blood glucose group and IGT group. Newly increased hypertension patients reached 1 739. Among them, 25.8% required antihypertensive drugs for treatment. According to the 6th demographic census data of Guizhou Province in 2010, it was estimated that newly increased hypertensive patients aged 40-79 years in prediabetes patients reached 123 000, among them, 20 000 required treatment. Newly increased hypertensive patients aged 40-79 years in diabetes patients reached 68 000, among them, 21 000 required treatment. Conclusions ACC/AHA Hypertension Guide in 2017 will obviously increase hypertension′s prevalence rate of people with different glucose metabolic status in 40-49 years old. The treatment ratio of hypertension groups with diabetes and prediabetes is considerably high. As a result, social medical burdens is going to aggravate. Key words: Prediabetes state; Diabetes mellitus; Hypertension; Guide; Prevalence