2017 ACC/AHA Hypertension Guidelines

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2017 ACC/AHA Hypertension Guidelines
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2]

Guidelines for Lifestyle modification:

Nonpharmacological Interventions

Class I

"1. Weight loss is recommended to reduce BP in adults with elevated BP or hypertension who are overweight or obese.(Level of Evidence: A) "

"2. A heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, that facilitates achieving a desirable weight is recommended for adults with elevated BP or hypertension.(Level of Evidence: A) "

"3. Sodium reduction is recommended for adults with elevated BP or hypertension.(Level of Evidence: A) "

"4. Potassium supplementation, preferably in dietary modification, is recommended for adults with elevated BP or hypertension, unless contraindicated by the presence of chronic kidney disease (CKD) or use of drugs that reduce potassium excretion.(Level of Evidence: A) "

"5. Increased physical activity with a structured exercise program is recommended for adults with elevated BP or hypertension.(Level of Evidence: A) "

"6. Adult men and women with elevated BP or hypertension who currently consume alcohol should be advised to drink no more than 2 and 1 standard drinks* per day, respectively.(Level of Evidence: A) "

In the United States, 1 “standard” drink contains roughly 14 g of pure alcohol, which is typically found in 12 oz of regular beer (usually about 5% alcohol), 5 oz of wine (usually about 12% alcohol), and 1.5 oz of distilled spirits (usually about 40% alcohol)

Strategies to Promote Lifestyle Modification

Class I

"1. Effective behavioral and motivational strategies to achieve a healthy lifestyle (i.e., tobacco cessation, weight loss, moderation in alcohol intake, increased physical activity, reduced sodium intake, and consumption of a healthy diet) are recommended for adults with hypertension.(Level of Evidence: C-EO) "

Structured, Team-Based Care Interventions for Hypertension Control

Class I

"1. A team-based care approach is recommended for adults with hypertension.(Level of Evidence: A) "

Electronic Health Record (EHR) and Patient Registries

Class I

"1. Use of the EHR and patient registries is beneficial for identification of patients with undiagnosed or undertreated hypertension.(Level of Evidence: B-NR) "

"2. Use of the EHR and patient registries is beneficial for guiding quality improvement efforts designed to improve hypertension control .(Level of Evidence: B-NR) "

Telehealth Interventions to Improve Hypertension Control

Class IIa

"1. Telehealth strategies can be useful adjuncts to interventions shown to reduce BP for adults with hypertension.(Level of Evidence: A) "

"2. Use of performance measures in combination with other quality improvement strategies at patient-, provider-, and system-based levels is reasonable to facilitate optimal hypertension control.(Level of Evidence: B-NR) "

Quality Improvement Strategies

Class IIa

"1. Use of quality improvement strategies at the health system, provider, and patient levels to improve identification and control of hypertension can be effective.(Level of Evidence: B-R) "

Quality Improvement Strategies

Class IIa

"1. Financial incentives paid to providers can be useful in achieving improvements in treatment and management of patient populations with hypertension.(Level of Evidence: B-R) "

"1. Health system financing strategies (e.g., insurance coverage and copayment benefit design) can be useful in facilitating improved medication adherence and BP control in patients with hypertension.(Level of Evidence: B-NR) "

The Plan of Care for Hypertension

Class I

"1. Every adult with hypertension should have a clear, detailed, and current evidence-based plan of care that ensures the achievement of treatment and self-management goals, encourages effective management of comorbid conditions, prompts timely follow-up with the healthcare team, and adheres to CVD guideline-directed medical therapy (GDMT).(Level of Evidence: C-EO) "