Abstract 199: The Clinical Outcome and Economic Impact of the 2017 ACC/AHA Guidelines on Hypertension in China

Background: In 2017, the American College of Cardiology (ACC) and the American Heart Association (AHA) published guidelines on the diagnosis and treatment of high BP (blood pressure) in adults. The impact of clinic outcome and economy need to be estimated for adopting the guidelines in China. Methods: Data from a nationally representative sample in China were analyzed. The prevalence and treatment were calculated based on the criteria of the 2017 ACC/AHA and 2010 Chinese guidelines among participants aged ≥35 years old. Direct medical costs, as well as the averted disability adjusted of life years (DALYs) and cost saving from cardiovascular disease (CVD) events prevented by controlling hypertension, were also estimated. Results: The prevalence and treatment rate of hypertension was 32.0% and 43.4% according to the 2010 Chinese guidelines. Based on the 2017 ACC/AHA guidelines, another 24.5% of the adult population (estimated 168.1 million) would be classified with hypertension; of which about 32.1 million hypertensive patients would need to be pharmaceutically treated to reach the current treatment rate of 43.4% ( Table 1 ). As a result, an additional 288.1 billion Chinese currency Renminbi (RMB) of direct medical cost will be required for the lifetime. The new guidelines would reduce lifetime costs by 22.77 billion RMB, while preventing 1,292,881 DALYs lost due to CVD events ( Table 2 ). Conclusions: Application of the 2017 AHA/ACC guidelines in China will substantially increase the prevalence of hypertension and produce a large increase of therapy costs, although it would prevent CVD events and save DALYs. The newly released 2018 Chinese Blood Pressure Management Guidelines defined normal BP as systemic BP<140/diastolic BP<90 mm Hg.