PMID- 31248050
OWN - NLM
STAT- MEDLINE
DCOM- 20200102
LR  - 20200225
IS  - 1648-9144 (Electronic)
IS  - 1010-660X (Print)
IS  - 1010-660X (Linking)
VI  - 55
IP  - 7
DP  - 2019 Jun 26
TI  - Agreement between 2017 ACC/AHA Hypertension Clinical Practice Guidelines and 
      Seventh Report of the Joint National Committee Guidelines to Estimate Prevalence 
      of Postmenopausal Hypertension in a Rural Area of Bangladesh: A Cross Sectional 
      Study.
LID - 10.3390/medicina55070315 [doi]
LID - 315
AB  - Background and objectives: Justification for application of 2017 American College 
      of Cardiology/American Heart Association (ACC/AHA) guidelines to detect 
      hypertension (HTN) among Bangladeshi population is understudied. This prompted us 
      to examine the level of agreement between 2017 ACC/AHA and Joint National 
      Committee 7 (JNC 7) guidelines to detect postmenopausal HTN in a rural area of 
      Bangladesh. Materials and Methods: This cross-sectional study recruited 265 
      postmenopausal women of 40-70 years of age who visited a rural primary health 
      care centre of Bangladesh. HTN was diagnosed based on two definitions: the JNC 7 
      guidelines (SBP >/= 140 or DBP >/= 90 mmHg), and the 2017 ACC/AHA guidelines (SBP >/= 
      130 mmHg, or DBP >/= 80 mmHg). The prevalence of postmenopausal HTN, its sub-types 
      and stages were reported and compared using frequency and percentage. Agreement 
      was evaluated using Cohen's Kappa (kappa), Prevalence-Adjusted Bias-Adjusted Kappa 
      (PABAK) and First-order Agreement Coefficient (AC1). Results: The prevalence of 
      postmenopausal HTN was 67.5% and 41.9% using 2017 ACC/AHA and JNC 7 guidelines 
      respectively. Among the HTN sub-types and stages, the new 2017 ACC/AHA guideline 
      classified higher proportion of respondents as having isolated systolic 
      hypertension (ISH) (42.6%) and stage 2 HTN (35.8%) compared to JNC 7 (28.7% and 
      6.8% respectively). On the other hand, the JNC 7 guideline identified more 
      respondents as pre-hypertensive (32.5%) when compared with the 2017 ACC/AHA 
      guideline (3.8%). Between two guidelines, highest agreement was observed for ISH 
      (86.03%) and those had pre-hypertension/elevated blood pressure (71.3%). 
      Similarly, Landis & Koch's approach detected highest agreement for ISH (kappa = 0.74, 
      substantial; PABAK = 0.76, substantial; AC1 = 0.84, excellent; p < 0.001) and 
      pre-hypertension/elevated blood pressure (kappa= 0.12, slight; PABAK = 0.42, 
      moderate; AC1 = 0.83, excellent; p < 0.001). Conclusions: The 2017 ACC/AHA HTN 
      guideline reported high agreement and detected more participants as hypertensive 
      when compared with JNC 7 guideline for Bangladeshi postmenopausal women that 
      demands further large-scale study in general population to clarify the current 
      findings more precisely.
FAU - Barua, Lingkan
AU  - Barua L
AD  - Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, 
      125/1 Darus Salam, Mirpur-1, Dhaka-1216, Bangladesh. lingkanbarua@gmail.com.
FAU - Faruque, Mithila
AU  - Faruque M
AD  - Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, 
      125/1 Darus Salam, Mirpur-1, Dhaka-1216, Bangladesh. mithilafaruque@gmail.com.
FAU - Banik, Palash Chandra
AU  - Banik PC
AD  - Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, 
      125/1 Darus Salam, Mirpur-1, Dhaka-1216, Bangladesh. palashcbanik@gmail.com.
FAU - Ali, Liaquat
AU  - Ali L
AD  - Department of Biochemistry and Cell Biology, Bangladesh University of Health 
      Sciences, 125/1 Darus Salam, Mirpur-1, Dhaka-1216, Bangladesh. 
      liaquat304@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20190626
PL  - Switzerland
TA  - Medicina (Kaunas)
JT  - Medicina (Kaunas, Lithuania)
JID - 9425208
SB  - IM
MH  - Adult
MH  - Aged
MH  - Bangladesh/epidemiology
MH  - Blood Pressure
MH  - Blood Pressure Determination/methods
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Hypertension/*diagnosis/epidemiology
MH  - Middle Aged
MH  - Postmenopause/*physiology
MH  - Prevalence
MH  - Risk Factors
MH  - Rural Population/statistics & numerical data
PMC - PMC6681048
OTO - NOTNLM
OT  - American College of Cardiology/American Heart Association
OT  - Bangladesh
OT  - Joint National Committee
OT  - agreement
OT  - hypertension
OT  - postmenopausal women
COIS- The authors declare no conflict of interest.
EDAT- 2019/06/30 06:00
MHDA- 2020/01/03 06:00
PMCR- 2019/06/26
CRDT- 2019/06/29 06:00
PHST- 2019/05/08 00:00 [received]
PHST- 2019/06/24 00:00 [revised]
PHST- 2019/06/25 00:00 [accepted]
PHST- 2019/06/29 06:00 [entrez]
PHST- 2019/06/30 06:00 [pubmed]
PHST- 2020/01/03 06:00 [medline]
PHST- 2019/06/26 00:00 [pmc-release]
AID - medicina55070315 [pii]
AID - medicina-55-00315 [pii]
AID - 10.3390/medicina55070315 [doi]
PST - epublish
SO  - Medicina (Kaunas). 2019 Jun 26;55(7):315. doi: 10.3390/medicina55070315.