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- The definition of isolated diastolic hypertension (IDH) was changed in the 2017 ACC/AHA guideline, and this study compared the prevalence of IDH and the association of IDH with outcomes under the new definition versus the 2003 Joint National Committee (JNC7) definition. Based on data from 9590 adult participants in the NHANES and 8703 adults in the ARIC study, the prevalence of IDH was 1.3% and 6.5% by the 2003 and 2017 definitions, respectively.
- The 2017 ACC/AHA guidelines have increased the estimated prevalence of IDH, but no associations were identified between IDH and elevated cardiovascular risk.
We studied this question in a recent paper in JAMA. The new IDH cut-point increases the prevalence of this condition by approximately 5% of the US adult population. That equates to over 10 million. However, we found no association between IDH as defined by the new guideline and adverse cardiovascular outcomes.
This suggests that a BP target of 130/90 mm Hg might have been better, although more research is needed.