The new guidelines of high blood pressure substantially increase prevalence of hypertension in Argentina

Hypertension occupies the first place for global disease burden and all-cause mortality.1 Moreover, the evidence favoring antihypertensive drug therapy to reduce cardiovascular events and mortality is conclusive.2 In Argentina, the Third National Risk Factor Survey determined that 34.1% of the population received the diagnosis of high blood pressure.3 By the end of 2017, the American College of Cardiology (ACC) and the American Heart Association (AHA) published the new guideline for the detection, prevention, management and treatment of high blood pressure.4 This guideline is an update of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7). Compared with the JNC7 guideline, the 2017 ACC/AHA guideline recommends the use of lower systolic blood pressure (SBP) and diastolic blood pressure (DBP) values to define hypertension. On the other hand, these new recommendations suggest taking into account the cardiovascular risk estimated with the new score for cardiovascular disease used by the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to determine which patients with stage 1 hypertension should receive antihypertensive drugs.5 As a consequence, the number of patients diagnosed with hypertension would increase considerably and many patients should be treated with antihypertensive drugs. The objectives of this study were: 1) to determine what proportion of non-hypertensive patients according to the previous recommendations in primary prevention were diagnosed as hypertensive by the 2017 ACC/AHA guideline; 2) to establish how many patients should receive pharmacological treatment after applying the new recommendations; 3) To determine reasons to justify the indication of antihypertensive therapy.