Abstract
The 2017 US guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults proposed the diagnosis of hypertension at 130/80 mmHg, while the European Society of Cardiology and 2020 Brazilian Guidelines of Hypertension maintain the 140/90 mmHg cut-off. We aimed to evaluate how the cut-off established by the American Heart Association guidelines would impact the prevalence of hypertension in the ELSA-Brasil cohort and compare the clinical characteristics among these subgroups. The participants were part of the ongoing ELSA-Brasil multicenter cohort, with baseline data collected between 2008 and 2010, consisting of 15,105 public servants of both sexes aged 35 to 74 years. Hypertension (≥140 or ≥90 mmHg or use of antihypertensive drugs in the last two weeks if below these values) prevalence was 36.2% (95%CI: 35.4-36.9, n=5,456) with the Brazilian cut-off and 51.4% (95%CI: 50.6-52.1, n=7,756) when considering the US cut-off (SBP≥130 or DBP≥80 mmHg). In general, those with high blood pressure (HBP) presented an intermediate-risk profile compared to the hypertension group. Lowering the hypertension cut-off caused an absolute increase of 15.2% in the prevalence of hypertension in the sample of public servants studied. HBP individuals showed intermediate-risk profile between normal blood pressure and hypertension and represented a large fraction of the population who may benefit from treatment.