Provider Insider

Pharmacy integration insights

Winter 2018 | Issue No. 2

2017 American College of Cardiology/American Heart Association Hypertension Guidelines: Lower blood pressure goals recommended for most patients

 

 

Dr. Joseph Saseen
Dr. Joseph Vande Griend

UCHealth Integrated Network provides access to clinical experts, and we are privileged to have hypertension expertise from Joseph Saseen, PharmD, professor and vice chair with the University of Colorado Skaggs School of Pharmacy.

 

In the very first episode of our “Clinical Pharmacy Insights” podcast, I ask Dr. Saseen to share his thoughts on the important changes to hypertension guidelines and how the changes might impact clinical practice.

 

Dr. Saseen holds an appointment with the University of Colorado School of Medicine, Department of Family Medicine, and has practiced as a clinical pharmacist at UCHealth A.F. Williams Family Medicine Clinic – Stapleton for nearly 20 years. He is a nationally and internationally recognized speaker on the topic of hypertension, has authored multiple book chapters on hypertension, and he has served as a clinical expert reviewer for the 2017 ACC/AHA hypertension guidelines.

 

Expert recommendations for best use of medication and appropriate clinical targets for chronic disease management are routinely updated as new evidence and clinical information become available. Clinical pharmacists can help providers stay updated to ensure treatment adheres to guideline recommendations.

 

The American College of Cardiology and American Heart Association recently published an updated guideline for the treatment of hypertension.1 The previous standard of care hypertension guidelines were from JNC 7 and were published in 2003. Since that time, there have been other expert recommendations for important changes based on recent studies, most notably the SPRINT Trial, “A Randomized Trial of Intensive versus Standard Blood-Pressure Control.”2 The following are important takeaways from the updated 2017 guidelines:

  • New blood pressure (BP) goal of <130/80 mmHg for most patients with hypertension
  • Change in BP classification; notably ≥130/80 mmHg is now used to define hypertension
  • Greater emphasis on verifying hypertension diagnosis, utilizing both in-office strategies and home BP measurements to ensure accuracy
  • No change in first-line therapy options: ACE inhibitor, ARB, thiazide diuretic and CCB

For more detailed information, here are links to documents summarizing the 2017 ACC/AHA hypertension guidelines. These provide tables and figures with blood pressure recommendations and treatment algorithms.

 

Click here to view the Brief Summary Document

 

Click here to view the Detailed Summary Document

 

Finally, I encourage you to watch the video below with Dr. Saseen showing the proper blood pressure measurement technique developed with support from the AHA Million Hearts Campaign. The proper blood pressure measurement technique is emphasized in the updated 2017 guidelines.

 

 

I look forward to sharing more “Clinical Pharmacy Insights” during our podcast next quarter. If you have any suggestions for future episodes, please reach out to me with your thoughts.

 

Thank you for listening!

 

Joseph Vande Griend, PharmD, BCPS, BCGP
Director of Population Health Pharmacy
UCHealth
joseph.vandegriend@uchealth.org

 

Special thanks to Kristi Smith, PharmD student; Scott Pearson, PharmD, PGY2 pharmacy resident; and Joseph Saseen, PharmD, and professor of clinical pharmacy, all with the University of Colorado Skaggs School of Pharmacy, for their contributions to this article.

References:

  1. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2017; doi: 10.1161/HYP.0000000000000065. [Epub ahead of print].
  2. SPRINT Research Group. A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med. 2015. 373(22): 2103-16.