@article{d3bbe7f489c04257a8702f17533da0ec,
title = "Systematic review for the 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",
abstract = "Objective-To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy? Methods-Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question. We performed analyses using traditional frequentist statistical and Bayesian approaches, including random-effects Bayesian network meta-analyses. Results-Our results suggest that: 1) There is a modest but significant improvement in systolic BP in randomized controlled trials of self-measured BP versus usual care at 6 but not 12 months, and for selected patients and their providers self-measured BP may be a helpful adjunct to routine office care. 2) systolic BP lowering to a target of <130 mm Hg may reduce the risk of several important outcomes including risk of myocardial infarction, stroke, heart failure, and major cardiovascular events. No class of medications (ie, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, calcium channel blockers, or beta blockers) was significantly better than thiazides and thiazide-like diuretics as a first-line therapy for any outcome.",
keywords = "AHA Scientific Statements, Antihypertensive drug class, Blood pressure, Cardiovascular disease, Evidence Review Committee, Home blood pressure monitoring, Hypertension, Meta-analysis, Risk reduction, Targets, Treatment outcomes",
author = "{American College of Cardiology} and {American College of Cardiology/American Heart Association} and Reboussin, {David M.} and Allen, {Norrina B.} and Griswold, {Michael E.} and Eliseo Guallar and Yuling Hong and Lackland, {Daniel T.} and Miller, {Edgar R.} and Tamar Polonsky and Thompson-Paul, {Angela M.} and Suma Vupputuri and Levine, {Glenn N.} and O'Gara, {Patrick T.} and Halperin, {Jonathan L.} and Immediate Past and Al-Khatib, {Sana M.} and Beckman, {Joshua A.} and Birtcher, {Kim K.} and Biykem Bozkurt and Brindis, {Ralph G.} and Cigarroa, {Joaquin E.} and Curtis, {Lesley H.} and Anita Deswal and Fleisher, {Lee A.} and Federico Gentile and Samuel Gidding and Goldberger, {Zachary D.} and Hlatky, {Mark A.} and John Ikonomidis and Joglar, {Jos{\'e} A.} and Laura Mauri and Pressler, {Susan J.} and Barbara Riegel and Wijeysundera, {Duminda N.} and Walsh, {Mary Norine} and Shalom Jacobovitz and Oetgen, {William J.} and Elma, {Mary Anne} and Amelia Scholtz and Katherine Sheehan and Abdullah, {Abdul R.} and Naira Tahir and Warner, {John J.} and Nancy Brown and Robertson, {Rose Marie} and Whitman, {Gayle R.} and Jody Hundley",
note = "Funding Information: This table represents all relationships of ERC members with industry and other entities that were reported by authors, including those not deemed to be relevant to this document, at the time this document was under development. The table does not necessarily reflect relationships with industry at the time of publication. A person is deemed to have a significant interest in a business if the interest represents ownership of ≥5% of the voting stock or share of the business entity, or ownership of ≥$5,000 of the fair market value of the business entity; or if funds received by the person from the business entity exceed 5% of the person{\textquoteright}s gross income for the previous year. Relationships that exist with no financial benefit are also included for the purpose of transparency. Relationships in this table are modest unless otherwise noted. Please refer to http://www.acc.org/guidelines/about-guidelines-and-clinical-documents/relationships-with-industry-policy for definitions of disclosure categories or additional information about the ACC/AHA Disclosure Policy for Writing Committees. *Indicates significant relationship. †Dr. Vupputuri entered into a relationship as a subcontracted co-investigator on July 5, 2017 via the MidAtlantic Permanente Research Institute and the Center for Health Research at Kaiser Permanente Northwest, as part of a retrospective cohort study funded by Sanofi, Inc. The contract itself was between the MidAtlantic Permanente Research Institute and the Center for Health Research at Kaiser Permanente Northwest. Although funding was processes via two research organizations, this was still considered to be “RWI” and is thus listed in the disclosure table. At this time, the ERC had already worked approximately three years, and all data gathering, analyses, and conclusions had already been formulated. Nevertheless, relevant analyses and sections of the ERC report were independently scientifically reviewed by David M. Reboussin, Norrina B. Allen, Daniel T. Lackland, Michael E. Griswold, Edgar (Pete) R. Miller III, Eliseo Guallar, Yuling Hong, and Angela M. Thompson-Paul, and this review and the finalized ERC report were then re-vetted and voted on for endorsement by the ERC and the hypertension guideline writing committee. ‡On March 1, 2018 (after publication of this Systematic Review), Dr. Polonsky, after having reviewed her listing on the CMS Open Payments Data website, realized that she had been a local PI in the STRENGTH trial, supported by AstraZeneca, and promptly reported this to the Task Force. Only one patient was recruited, and Dr. Polonsky did not receive any direct salary support, but by ACC/AHA standards, this would constitute a relationship with industry (RWI) and thus, in the interest of full transparency, this footnote has been added. Publisher Copyright: {\textcopyright} 2017 by the American College of Cardiology Foundation and the American Heart Association, Inc.",
year = "2018",
month = jun,
doi = "10.1161/HYP.0000000000000067",
language = "English (US)",
volume = "71",
pages = "E116--E135",
journal = "Hypertension",
issn = "0194-911X",
publisher = "Lippincott Williams and Wilkins",
number = "6",
}
