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Research Letter
March 16, 2020

Generalizability of Clinical Trials Supporting the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline

Author Affiliations
  • 1Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • 2Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • 3Department of Epidemiology and Population Health, Stanford University, Stanford, California
  • 4Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
  • 5Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • 6UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, California
  • 7Division of General Medicine, Columbia University, New York, New York
  • 8Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, San Francisco, California
JAMA Intern Med. Published online March 16, 2020. doi:10.1001/jamainternmed.2020.0051

The 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline for high blood pressure (BP) management lowered thresholds for diagnosing and treating hypertension to 130/80 mm Hg for all adults.1 These recommendations were based primarily on the results of the Systolic Blood Pressure Intervention Trial (SPRINT) and Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial,1-3 which recruited patients at increased cardiovascular risk and imposed exclusion criteria related to comorbidities, life expectancy, and likelihood of medication adherence.2,3 In the present study, we used National Health and Nutrition Examination Survey (NHANES) data to evaluate whether patients enrolled in the SPRINT and ACCORD trials are representative of the US adult population who met criteria for additional pharmacotherapy by the ACC/AHA guideline.

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    1 Comment for this article
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    Robert Wang, M.D., Ph.D. | Private Practice
    Extremely useful letter in placing published guidelines in appropriate context for practitioners.
    CONFLICT OF INTEREST: None Reported
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