Researchers assessed the risk for CVD events among adults and recommended antihypertensive medication initiation or intensification based on 2017 ACC / AHA blood pressure guideline. Participants (aged ≥45 years) were part of the REGARDS (REasons for Geographic and Racial Differences in Stroke) study cohort, and their systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured twice at baseline (2003 to 2007) and averaged. CVD events (stroke, coronary heart disease, and heart failure) were tracked through 2014.

The researchers found that among participants not taking antihypertensive medication, 34.4% were recommended pharmacological antihypertensive treatment initiation. Among participants recommended antihypertensive medication initiation with SBP / DBP ≥140 / 90 mm Hg.

The CVD event rate was 22.7 per 1,000 person-years versus 20.5 for those recommended antihypertensive medication initiation with SBP / DBP 130 to 139/80 to 89 mm Hg and 3.4 for those with SBP / DBP 130 to 139/80 to 89 mm Hg not recommended antihypertensive medication initiation.

The authors analyzed data for black and white REGARDS (REasons for Geographic And Racial Differences in Stroke) study participants (age ≥45 years). Systolic BP (SBP) and diastolic BP (DBP) were measured twice at baseline (2003 to 2007) and averaged.

Cardiovascular Events

Participants not taking (n = 14,039) and taking (n = 15,179) antihypertensive medication were categorized according to their recommendations for antihypertensive medication initiation and intensification by the 2017 ACC/AHA guideline. Overall, 4,094 CVD events (stroke, coronary heart disease, and heart failure) occurred by December 31, 2014.

Antihypersensitive Medication

Just under two-thirds of participants taking antihypertensive medication (62.8 percent) were recommended treatment intensification. Among participants recommended treatment intensification, the CVD event rate per 1,000 person-years was 33.6 and 22.

Implementing the 2017 ACC / AHA guideline would direct antihypertensive medication initiation and intensification to adults with high CVD risk. Several authors disclosed financial ties to the pharmaceutical industry.