HIGHLIGHTS FROM THE 2017 ACC/AHA HYPERTENSION GUIDELINES (Invited Lecture)



Wilbert S. Aronow, M.D., Westchester Medical Center/New York Medical College, Valhalla, NY, USA

A normal blood pressure (BP) is < 120/80 mm Hg. A systolic BP between 120-129 mm Hg with a diastolic BP < 80 mm Hg should be treated by lifestyle measures. Treat with lifestyle measures plus BP lowering drugs for secondary prevention of recurrent cardiovascular disease events in persons with clinical cardiovascular disease (coronary heart disease, congestive heart failure, and stroke) and an average systolic BP of =130 mm Hg or an average diastolic BP = 80 mm Hg. Treat with lifestyle measures plus BP lowering drugs for primary prevention of cardiovascular disease in persons with an estimated 10-year risk of atherosclerotic cardiovascular disease (ASCVD) using the ASCVD risk calculator = 10% and an average systolic BP =130 mm Hg or an average diastolic BP =80 mm Hg. Treat with lifestyle measures plus BP lowering drugs for primary prevention of cardiovascular disease in persons with an estimated 10-year risk of ASCVD of < 10% and an average systolic BP =140 mm Hg or an average diastolic BP = 90 mm Hg. Initiate antihypertensive drug therapy with 2 first-line drugs from different classes either as separate agents or in a fixed-dose combination in persons with a BP =140/90 mm Hg or with a BP > 20/10 mm Hg above their blood pressure target. Antihypertensive drug treatment for primary hypertension in non-blacks with primary hypertension < and =60 years of age, in blacks with hypertension, and in persons with different comorbidities will be discussed.