ArticleBMC public health2020
Insight into blood pressure targets for universal coverage of hypertension services in Iran: the 2017 ACC/AHA versus JNC 8 hypertension guidelines.
Article in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Antihypertensive drug effects on long-term blood pressure: an individual-level data meta-analysis of randomised clinical trials.Heart (British Cardiac Society) · 2022Pooled it
- Pooled it
- Association of plasma acylcarnitines and amino acids with hypertension: A nationwide metabolomics study.PloS one · 2023Trial
- Association between hypertension awareness and preventive health behaviors among healthcare workers: evidence from the SHAHWAR study.BMC cardiovascular disorders · 2026Article
- Article
- Global trends in hypertension prevalence, awareness, treatment, and control.Current opinion in nephrology and hypertension · 2026Review
- Article
- Demographic and metabolic risk factors for non-communicable diseases in Iran: insights from a prospective cohort study.Journal of diabetes and metabolic disorders · 2025Article
- A decision rule algorithm for the detection of patients with hypertension using claims data.Journal of diabetes and metabolic disorders · 2025Article
- Stroke Risk Associated With Lowering Elevated Blood Pressure in Patients With Transient Ischemic Attack.Cureus · 2025Article
- Patterns of general and abdominal obesity and their association with hypertension control in the iranian hypertensive population: insights from a nationwide study.BMC public health · 2025Article
- The Role of Lifestyle Modifications in Preventing and Managing Systemic Hypertension: Current Guidelines and Future Directions.Annals of African medicine · 2025Article
- Article
- 'Inequalities in prevalence of hypertension, prehypertension, anti-hypertensive coverage, awareness, and effective treatment in 429 districts of Iran; a population-based STEPS 2016 small area spatial estimation model'.Journal of diabetes and metabolic disorders · 2023Article
- Prevalence and Awareness of Hypertension among a Rural Jazan Population.Healthcare (Basel, Switzerland) · 2023Article
- Action status and willingness to change health-promoting behaviors during the COVID-19 pandemic among elementary school children: a study based on Prochaska's stages of behavior change theory (TTM).BMC public health · 2023Article
- Metabolic risk factors attributed burden in Iran at national and subnational levels, 1990 to 2019.Frontiers in public health · 2023Article
- Article
- Inequality in prevalence, awareness, treatment, and control of hypertension in Iran: the analysis of national households' data.BMC public health · 2022Article
- Evidence for an expanded hypertension care cascade in low- and middle-income countries: a scoping review.BMC health services research · 2022Article
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Abstract
backgroundWe compared the prevalence, awareness, treatment, and control of hypertension in Iran based on two hypertension guidelines; the 2017 ACC/AHA -with an aggressive blood pressure target of 130/80 mmHg- and the commonly used JNC8 guideline cut-off of 140/90 mmHg. We shed light on the implications of the 2017 ACC/AHA for population subgroups and high-risk individuals who were eligible for non-pharmacologic and pharmacologic therapies.
methodsData was obtained from the Iran national STEPS 2016 study. Participants included 27,738 adults aged ≥25 years as a representative sample of Iranians. Regression models of survey design were used to examine the determinants of prevalence, awareness, treatment, and control of hypertension.
resultsThe prevalence of hypertension based on JNC8 was 29.9% (95% CI: 29.2-30.6), which soared to 53.7% (52.9-54.4) based on the 2017 ACC/AHA. The percentage of awareness, treatment, and control were 59.2% (58.0-60.3), 80.2% (78.9-81.4), and 39.1% (37.4-40.7) based on JNC8, which dropped to 37.1% (36.2-38.0), 71.3% (69.9-72.7), and 19.6% (18.3-21.0), respectively, by applying the 2017 ACC/AHA. Based on the new guideline, adults aged 25-34 years had the largest increase in prevalence (from 7.3 to 30.7%). They also had the lowest awareness and treatment rate, contrary to the highest control rate (36.5%) between age groups. Compared with JNC8, based on the 2017 ACC/AHA, 24, 15, 17, and 11% more individuals with dyslipidaemia, high triglycerides, diabetes, and cardiovascular disease events, respectively, fell into the hypertensive category. Yet, based on the 2017 ACC/AHA, 68.2% of individuals falling into the hypertensive category were eligible for receiving pharmacologic therapy (versus 95.7% in JNC8). LDL cholesterol< 130 mg/dL, sufficient physical activity (Metabolic Equivalents≥600/week), and Body Mass Index were found to change blood pressure by - 3.56(- 4.38, - 2.74), - 2.04(- 2.58, - 1.50), and 0.48(0.42, 0.53) mmHg, respectively.
conclusionsSwitching from JNC8 to 2017 ACC/AHA sharply increased the prevalence and drastically decreased the awareness, treatment, and control in Iran. Based on the 2017 ACC/AHA, more young adults and those with chronic comorbidities fell into the hypertensive category; these individuals might benefit from earlier interventions such as lifestyle modifications. The low control rate among individuals receiving treatment warrants a critical review of hypertension services.
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