New AHA/ACA/ASH Hypertension Guidelines: Lead Author Discusses Treatments and Controversies
On March 31, 2015, the American Heart Association (AHA), the American College of Cardiology (ACC), and the American Society of Hypertension (ASH) issued a new scientific statement entitled “Treatment of Hypertension in Patients with Coronary Heart Disease.”1 This article features an interview with Clive Rosendorff, MD, PhD, DScMed, chair of the writing committee, who discusses what's new in the guideline, and addresses areas of controversy. Dr. Rosendorff is Professor of Medicine (Cardiology), Mount Sinai School of Medicine, New York, NY, and Director of Graduate Medical Education, the James J. Peters V.A. Medical Center, Bronx, NY.
What is the history of the new recommendations?
The current statement serves as an update to the American Heart Association Council for High Blood Pressure Research and the Council on Clinical Cardiology and Epidemiology and Prevention” published in 2007.2 By agreement with the sponsoring societies, we decided to confine this statement to exclusively to hypertension in patients with established coronary artery disease (CAD) because the 2007 statement was broader and included primary prevention. The AHA and ACC have established another writing committee to make recommendations regarding primary prevention of hypertension.
Another important development was that the Eighth Joint National Committee (JNC 8)'s hypertension guideline was released in December, 2013 and published in January, 2014.3 JNC 8 was initiated in March 2008 and completed in January, 2013. But in June, 2013, the NHLBI decided not to be involved in the generation of guidelines and recommendations. The expert panel independently published their report.4 I respect the authors, who are outstanding in their field. But the recommendations generated controversy and confusion among clinicians. Our new scientific statement is designed to review the most recent evidence and bring clarity to treatment of hypertension in patients with CAD.