American Academy of Family Physicians (AAFP) announced last week that it will not endorse new hypertension guidelines backed by the American Heart Association (AHA), the American College of Cardiology (ACC), and nine other organizations, citing concerns with methodology and perceived conflicts of interest.
The new BP treatment guidelines call for lowering the threshold for treating hypertension with lifestyle changes and medication as necessary to 130/80 mm Hg instead of the previous commonly accepted mark of 140/90 mm Hg.
Under the new guidelines, 46% of the US adult population would be considered to have high blood pressure (HBP), as opposed to the 32% under the 140/90 guidelines.
Instead, the AAFP’s Commission on Health of the Public and Science (CHPS) said in a press release last week that it will continue to endorse the 2014 guidelines developed by the Eighth Joint National Committee.
Those guidelines state that in the general population, for people aged 60 years and older, treatment should begin at 150/90 mm Hg, and at age younger than 60 years, treatment should start at 140/90 mm Hg.
AAFP President Michael Munger, MD, said in a statement: “The American Academy of Family Physicians formally reviewed the AHA/ACC hypertension guideline but it did not meet the criteria for endorsement nor affirmation of value. The AAFP was not involved in the development of the new guidelines and continues to endorse the 2014 Evidence-Based Guidelines for the Management of High Blood Pressure in Adults.
“In addition, in January 2017, the AAFP and ACP published the clinical practice guideline Hypertension in Adults Over 60. Family physicians approach hypertension treatment on an individualized basis, taking into account patients’ histories, risk factors, preferences and resources. We will maintain making informed decisions with patients while considering potential benefits and harm,” Dr Munger said.
David O’Gurek, MD, CHPS chair, said in an AAFP News article there were several reasons for declining to endorse the new AHA/ACC guidelines. Among them, he said, was that “the bulk of the guideline wasn’t based on a systematic evidence review.”
As an example, commission members stated that the new guideline gave a strong recommendation for using the unvalidated atherosclerotic cardiovascular disease risk assessment tool, which was developed by the AHA and ACC to help gauge whether medications were necessary for BP control.
“However, this recommendation wasn’t based on evidence that using the tool in this way improves outcomes,” the commission stated.
News Credit: Medscape
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