PMID- 31888171
OWN - NLM
STAT- MEDLINE
DCOM- 20200409
LR  - 20200409
IS  - 1660-4601 (Electronic)
IS  - 1661-7827 (Print)
IS  - 1660-4601 (Linking)
VI  - 16
IP  - 24
DP  - 2019 Dec 16
TI  - Comparison of the JNC7 and 2017 American College of Cardiology/American Heart 
      Association Guidelines for the Management of Hypertension in Koreans: Analysis of 
      Two Independent Nationwide Population-Based Studies.
LID - 10.3390/ijerph16245134 [doi]
LID - 5134
AB  - The optimal blood pressure (BP) guidelines in Asian populations have not been 
      determined. We compared all-cause and cardiovascular mortality based on the Joint 
      National Committee 7 (JNC7) and 2017 American College of Cardiology/American 
      Heart Association (ACC/AHA) guidelines. The National Health Insurance 
      System-National Health Screening Cohort (NHIS-HEALS) and Korea National Health 
      and Nutrition Examination Survey (KNHANES) were utilized. BPs were classified 
      into three groups according to each guideline, and survival rates were analyzed 
      with Kaplan-Meier curves and log-rank tests. Hazard ratios (HRs) were calculated 
      using multivariable cox regression analyses, and the discriminatory ability for 
      clinical outcomes was assessed by Harrell's C-indexes. The JNC7 guidelines 
      demonstrated a linear association between BP levels and survival outcomes. 
      Adjusted HRs from the JNC7 guidelines differentiated the hypertension group 
      (>/=140/90) from the pre (130/80-139/89) and normal (<130 and <80) BP groups in 
      clinical outcomes. In contrast, the 2017 ACC/AHA guidelines showed inconsistent 
      survival outcomes according to BP classification (normal: <120 and <80, elevated: 
      120-129, and <80, and HTN: >/=130/80). According to Harrell's C-indexes, the JNC7 
      guidelines had greater discrimination ability in survival outcomes in the 
      NHIS-HEALS dataset. Our results suggest that the JNC7 guidelines are more 
      appropriate than the 2017 ACC/AHA guidelines in Korean populations.
FAU - Choi, Won-Jun
AU  - Choi WJ
AUID- ORCID: 0000-0002-8233-9272
AD  - Family Medicine, Graduate School, Yonsei University College of Medicine, Seoul 
      03722, Korea.
FAU - Lee, Hye-Sun
AU  - Lee HS
AUID- ORCID: 0000-0001-6328-6948
AD  - Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 
      06273, Korea.
FAU - Hong, Jung Hwa
AU  - Hong JH
AD  - Institute of Health Insurance & Clinical Research, National Health Insurance 
      Service Ilsan Hospital, Seoul 10444, Korea.
FAU - Chang, Hyuk-Jae
AU  - Chang HJ
AUID- ORCID: 0000-0002-6139-7545
AD  - Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University 
      College of Medicine, Yonsei University Health System, Seoul 03722, Korea.
FAU - Lee, Ji-Won
AU  - Lee JW
AUID- ORCID: 0000-0002-2666-4249
AD  - Department of Family Medicine, Gangnam Severance Hospital, Yonsei University 
      College of Medicine, Seoul 06273, Korea.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20191216
PL  - Switzerland
TA  - Int J Environ Res Public Health
JT  - International journal of environmental research and public health
JID - 101238455
SB  - IM
MH  - Adult
MH  - Aged
MH  - American Heart Association
MH  - Cardiology/*standards/*statistics & numerical data
MH  - Female
MH  - Humans
MH  - Hypertension/*therapy
MH  - Male
MH  - Middle Aged
MH  - *Practice Guidelines as Topic
MH  - Proportional Hazards Models
MH  - Republic of Korea
MH  - Societies, Medical
MH  - Treatment Outcome
MH  - United States
PMC - PMC6950121
OTO - NOTNLM
OT  - blood pressure
OT  - guidelines
OT  - hypertension
OT  - mortality
COIS- Authors declare no conflict of interest.
EDAT- 2020/01/01 06:00
MHDA- 2020/04/10 06:00
PMCR- 2019/12/01
CRDT- 2020/01/01 06:00
PHST- 2019/11/08 00:00 [received]
PHST- 2019/12/13 00:00 [revised]
PHST- 2019/12/14 00:00 [accepted]
PHST- 2020/01/01 06:00 [entrez]
PHST- 2020/01/01 06:00 [pubmed]
PHST- 2020/04/10 06:00 [medline]
PHST- 2019/12/01 00:00 [pmc-release]
AID - ijerph16245134 [pii]
AID - ijerph-16-05134 [pii]
AID - 10.3390/ijerph16245134 [doi]
PST - epublish
SO  - Int J Environ Res Public Health. 2019 Dec 16;16(24):5134. doi: 
      10.3390/ijerph16245134.