The updated American College of Cardiology/American Heart Association (ACC/AHA) Guideline on the Treatment of Blood Cholesterol (GTBC) has been long-awaited since the latest update of the Adult Treatment Panel III (ATP III) guidelines in 2004. The updated GTBC recommends a significant paradigm shift in lipid-lowering drug therapy for atherosclerotic cardiovascular disease (ASCVD) risk reduction, which has led to questions regarding their content and their implementation.
The recommended classification is unchanged from the 2003 and 2007 ESH/ESC guidelines. Hypertension is defined as values >/=140 mmHg systolic blood pressure (SBP) and/or >/=90 mmHg diastolic blood pressure (DBP), based on the evidence from randomized controlled trials (RCTs) that in patients with these blood pressure (BP) values treatment-induced BP reductions are beneficial.
In addition to the prediction of cardiovascular risk, ambulatory blood-pressure monitoring, when used in conjunction with clinic blood-pressure assessments, is of potential value in a variety of other clinical conditions. Some of these conditions are:
The classification is based on the average of two or more properly measured, seated blood pressure readings on each of two or more office visits.
This classification equates with that of the European Society of Hypertension (ESH) and that of World Health Organization/ International Society of Hypertension (WHO/ISH), and is based on clinic blood pressure values. If systolic blood pressure and diastolic blood pressure fall into different categories, the higher value should be taken for classification.