Follow new BP guidelines to avoid heart disease

If new hypertension guidelines are followed sincerely, it could help us significantly prevent deaths owing to cardiovascular diseases (CVD) each year without increasing overall health care costs, an analysis conducted by researchers at Columbia University Medical Center (CUMC) found.

“Our findings clearly show that it would be worthwhile to significantly increase spending on office visits, home blood pressure monitoring and interventions to improve treatment adherence,” said lead author Andrew E. Moran, the Herbert Irving Assistant Professor of Medicine at CUMC.

“In fact, we could double treatment and monitoring spending for some patients - namely those with severe hypertension - and still break even,” he added.

In the new guidelines released by the US National Heart, Lung and Blood Institute, stage 1 hypertension is defined as a systolic BP of 140-159 mm Hg or a diastolic BP of 90-99 mm Hg.

Stage 2 or severe hypertension is a systolic BP of 160 mm Hg or higher or a diastolic BP of 100 mm Hg or higher.

The 2014 guidelines are less aggressive for some patients, shifting treatment targets to higher blood pressures.

Fewer patients need treatment under the new guidelines, but according to Moran “even with the more relaxed goals, an estimated 44 per cent of adults with hypertension, or 28 million people, still do not have their blood pressure adequately controlled”.

“Given rising health care costs and limited budgets, it is important to determine the cost-effectiveness of implementing the new guidelines and whether we should focus on specific patient subgroups,” added study leader Lee Goldman, Harold and Margaret Hatch Professor of the University.

The researchers found that full implementation of the new guidelines would save costs by reducing mortality and morbidity related to CVD.

“The overall message of our study is that every segment of our health care system, from small medical practices to large insurance companies, can benefit by improving treatment of hypertension,” Moran said.
The paper was published online in the New England Journal of Medicine.