000K utf8 1100 2021$c2021-02-17 1500 eng 2050 urn:nbn:de:hbz:464-20210412-152535-8 2051 10.1136/bmjopen-2020-039597 3000 Gronewold, Janine 3010 Dichgans, Martin 3010 Erbel, Raimund 3010 Hermann, Dirk M. 3010 Hoffmann, Barbara 3010 Jöckel, Karl-Heinz 3010 Kröger, Knut 3010 Kropp, Rene 3010 Lehmann, Nils 3010 Mahabadi, Amir A. 3010 Moebus, Susanne 3010 Stang, Andreas 3010 Weimar, Christian 4000 Population impact of different hypertension management guidelines based on the prospective population-based Heinz Nixdorf Recall study [Gronewold, Janine] 4209 Objective: Hypertension guidelines strongly differ between societies. The current American College of Cardiology/American Heart Association (ACC/AHA) guideline recommends higher proportions of the general population for antihypertensive medication than the previous American and European guidelines. How cardiovascular risk differs between persons with and without antihypertensive medication recommendation has not been examined. Additionally, the population impact of American, European and international guidelines has not been compared systematically within the same study population. Methods: We compared the prevalence of antihypertensive medication recommendation according to the American (Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 7 (JNC7), ACC/AHA 2017), European (European Society of Hypertension (ESH)/European Society of Cardiology (ESC) 2013/2018), and international (WHO/International Society of Hypertension (ISH) 2003, ISH 2020) guidelines in 3092 participants of the population-based Heinz Nixdorf Recall study not taking antihypertensive medication at the baseline examination (58.1±7.5 years, 48.7% males). We furthermore compared incident cardiovascular events during the 5-year follow-up between participants with and without antihypertensive medication recommendation. Results: The ACC/AHA 2017 guideline recommended the highest percentage of participants for antihypertensive medication (45.8%) compared with the JNC7 (37.2%), ESH/ESC 2013 (17.8%), ESC/ESH 2018 (26.7%), WHO/ISH 2003 (20.3%) or ISH 2020 (25.0%) guidelines. Participants with antihypertensive medication recommendation according to the ACC/AHA 2017 guideline had a significantly higher incidence of cardiovascular events during the 5-year follow-up compared with participants without this recommendation (2.5% vs 1.1%, p=0.003). Conclusions: Our results call for randomised controlled trials to investigate whether applying the stricter ACC/AHA 2017 recommendation leads to a reduction in cardiovascular disease. 4950 https://doi.org/10.1136/bmjopen-2020-039597$xR$3Volltext$534 4950 https://nbn-resolving.org/urn:nbn:de:hbz:464-20210412-152535-8$xR$3Volltext$534 4961 https://duepublico2.uni-due.de/receive/duepublico_mods_00074105 5051 610