Evidence map›Paper›PMID 30586736›Full record

ArticleCirculation2019

Potential Cardiovascular Disease Events Prevented with Adoption of the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline.

Adam P Bress, Lisandro D Colantonio, Richard S Cooper, Holly Kramer, John N Booth, Michelle C Odden, Kirsten Bibbins-Domingo, Daichi Shimbo, Paul K Whelton, Emily B Levitan and 6 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Guideline
  2. Guideline
  3. Blood Pressure Control and Mortality Among US Veterans.Hypertension (Dallas, Tex. : 1979) · 2026
    Article
  4. Article
  5. Review
  6. The Systolic Blood Pressure Intervention Trial: 10 Years Later.Journal of the American College of Cardiology · 2025
    Article
  7. Review
  8. Review
  9. Article
  10. Article
  11. Review
  12. Review
  13. Article
  14. Review
  15. Article
  16. Article
  17. Article
  18. The Burden of Resistant Hypertension Across the World.Current hypertension reports · 2022
    Review
  19. Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Adam P BressDepartment of Population Health Sciences, University of Utah, Salt Lake City, UT (A.B.P.).
Lisandro D ColantonioDepartment of Epidemiology (L.D.C., J.N.B., E.B.L. P.M.), University of Alabama at Birmingham, Birmingham, AL.
Richard S CooperDepartment of Public Health Sciences (R.S.C., H.K.), Loyola Medical Center, Maywood, IL.
Holly KramerDepartment of Public Health Sciences (R.S.C., H.K.), Loyola Medical Center, Maywood, IL.
John N BoothDepartment of Epidemiology (L.D.C., J.N.B., E.B.L. P.M.), University of Alabama at Birmingham, Birmingham, AL.
Michelle C OddenSchool of Biological and Population Health Sciences, Oregon State University, Corvallis, OR (M.C.O.).
Kirsten Bibbins-DomingoDepartment of Epidemiology and Biostatistics and Department of Medicine, University of California, San Francisco School of Medicine (K.B-D.).
Daichi ShimboDepartment of Medicine, Division of Cardiology (D.S.), Columbia University Medical Center, New York, NY.
Paul K WheltonDepartment of Epidemiology, Tulane University, New Orleans, LA (P.K.W.).
Emily B LevitanDepartment of Epidemiology (L.D.C., J.N.B., E.B.L. P.M.), University of Alabama at Birmingham, Birmingham, AL.
George HowardDepartment of Biostatistics (G.H.), University of Alabama at Birmingham, Birmingham, AL.
Brandon K BellowsDivision of General Medicine (B.K.B., A.E.M.), Columbia University Medical Center, New York, NY.
Dawn KleindorferDepartment of Neurology and Physical Rehabilitation, University of Cincinnati, Cincinnati, OH (D.K.).
Monika M SaffordDepartment of Medicine, Weill Cornell Medical College, New York, NY (M.M.S.).
Paul MuntnerDepartment of Epidemiology (L.D.C., J.N.B., E.B.L. P.M.), University of Alabama at Birmingham, Birmingham, AL.
Andrew E MoranDivision of General Medicine (B.K.B., A.E.M.), Columbia University Medical Center, New York, NY.

Funding

VCID and Stroke in a Bi-racial National CohortU01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2002 to 2022
$96.0M
Tulane COBRE in Cardiometabolic Diseases Clinical Research CoreP20GM109036 · NIGMS · TULANE UNIVERSITY OF LOUISIANA · PI Katherine Teresa Mills · 2016 to 2026
$25.3M
University of Alabama at Birmingham's Diabetes Research CenterP30DK079626 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Kirk Michael Habegger · 2013 to 2026
$19.5M
REGARDS - MI StudyR01HL080477 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI LEVITAN, EMILY B, SAFFORD, MONIKA M · 2006 to 2020
$11.6M
Understanding Cohort Effects on Stroke, VCID, and Cognition After Major Epidemiologic TransitionsR01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI MARY CUSHMAN, VIRGINIA J. HOWARD · 2001 to 2026
$8.8M
Patient Level Prediction of Clinical Outcomes and Cost-Effectiveness in SPRINT (Optimize-SPRINT)R01HL139837 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI BRESS, ADAM P, MORAN, ANDREW EDWARD · 2018 to 2021
$3.2M
Model Based Approach to Improving Hypertension Control in PopulationsR01HL130500 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI MORAN, ANDREW EDWARD · 2016 to 2019
$2.4M
Hypertension Management in Minority and Low-income PopulationsK24DK103992 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI BIBBINS-DOMINGO, KIRSTEN · 2014 to 2018
$917k
Genetic ancestry and antihypertensive medication responses in African AmericansK01HL133468 · NHLBI · UNIVERSITY OF UTAH · PI BRESS, ADAM P · 2016 to 2020
$787k
Comparing the value of intensive systolic blood pressure treatment implementation strategiesK01HL140170 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI BELLOWS, BRANDON K · 2018 to 2022
$709k
Midcareer Investigator Award in Patient-Oriented Research in Human HypertensionK24HL125704 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHIMBO, DAICHI · 2015 to 2019
$573k
Building Capacity for Cardiometabolic Outcomes ResearchK24HL111154 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI SAFFORD, MONIKA M · 2012 to 2015
$556k
NHLBI NIH HHS K01 HL133468NHLBI NIH HHS K01 HL140170NHLBI NIH HHS K24 HL111154NHLBI NIH HHS K24 HL125704NHLBI NIH HHS R01 HL080477NHLBI NIH HHS R01 HL130500NHLBI NIH HHS R01 HL139837NHLBI NIH HHS R13 HL144012NIDDK NIH HHS K24 DK103992NIDDK NIH HHS P30 DK079626NIGMS NIH HHS P20 GM109036NINDS NIH HHS R01 NS041588NINDS NIH HHS U01 NS041588
6 · The paper itself

Abstract

backgroundOver 10 years, achieving and maintaining 2017 ACC/AHA guideline goals could prevent 3.0 million (UR, 1.1-5.1 million), 0.5 million (UR, 0.2-0.7 million), and 1.4 million (UR, 0.6-2.0 million) cardiovascular disease (CVD) events compared with maintaining current blood pressure (BP) levels, achieving 2003 Seventh Joint National Committee Report goals, and achieving 2014 Eighth Joint National Committee goals, respectively. We estimated the number of cardiovascular disease events prevented and treatment-related serious adverse events incurred over 10 years among US adults with hypertension by achieving 2017 ACC/AHA guideline-recommended BP goals compared with (1) current BP levels, (2) achieving 2003 Seventh Joint National Committee Report BP goals, and (3) achieving 2014 Eighth Joint National Committee panel member report BP goals.

methodsUS adults aged ≥45 years with an indication for BP treatment were grouped according to recommendations for antihypertensive drug therapy in the 2017 ACC/AHA guideline, 2003 Seventh Joint National Committee Report, and 2014 Eighth Joint National Committee. Population sizes were estimated from the 2011 to 2014 National Health and Nutrition Examination Surveys. Rates for fatal and nonfatal CVD events (stroke, coronary heart disease, or heart failure) were estimated from the REGARDS (REasons for Geographic And Racial Differences in Stroke) study, weighted to the US population. CVD risk reductions with treatment to BP goals and risk for serious adverse events were obtained from meta-analyses of BP-lowering trials. CVD events prevented and treatment-related nonfatal serious adverse events over 10 years were calculated. Uncertainty surrounding main data inputs was expressed in uncertainty ranges (UR).

resultsOver ten years, achieving and maintaining 2017 ACC/AHA guideline goals compared with current BP levels, achieving 2003 Seventh Joint National Committee Report goals, or achieving 2014 Eighth Joint National Committee goals could prevent 3.0 million (UR, 1.1-5.1 million), 0.5 million (UR, 0.2-0.7 million), or 1.4 million (UR, 0.6-2.0 million) CVD events, respectively. Compared with current BP levels, achieving and maintaining 2017 goals could prevent 71.9 (UR, 26.6-122.3) CVD events per 1000 treated. Achieving 2017 guideline BP goals compared with current BP levels could also lead to nearly 3.3 million more serious adverse events over 10 years (UR, 2.2-4.4 million).

conclusionsAchieving and maintaining 2017 ACC/AHA BP goals could prevent a greater number of CVD events than achieving 2003 Seventh Joint National Committee Report or 2014 Eighth Joint National Committee BP goals but could also lead to more serious adverse events.

Indexed as

AgedAmerican Heart AssociationAntihypertensive AgentsBlood PressureCardiovascular DiseasesComputer SimulationDisease ProgressionFemaleGuideline AdherenceHumansHypertensionMaleMiddle AgedModels, TheoreticalNutrition SurveysPractice Guidelines as TopicAntihypertensive AgentsAmerican Heart Associationblood pressurecardiologycardiovascular diseasegoalshypertensionUnited States

Identifiers

PMID30586736
PMCPMC6311714

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.