Prevention & lipidsCross-sectional study
Shifting Thresholds
- simulation-based analysis
- nationally representative National Health and Nutrition Examination Survey data (2017-2020)
- survey-weighted estimates
Authors' conclusion
Adoption of the 2025 American College of Cardiology/American Heart Association guideline results in a minimal expansion of antihypertensive treatment eligibility. Results were robust across PREVENT model variants, supporting risk-based guideline implementation.
Study context
- Population
- U.S. adults aged 30 to 79 years in the National Health and Nutrition Examination Survey (2017–2020)weighted population 160 million
- Participants
- 5,578 adults
- Exposure
- antihypertensive treatment eligibility under the 2025 vs 2017 guidelines
- Outcome
- Antihypertensive treatment eligibility
Main finding
As reported in the abstract
- minimal net increase
- 0.7% (approximately 400,000 adults)
Observational data: associations, not effects.
Secondary outcomes
Concordance in eligibility
- consistently ineligible
- 63.3%
- consistently eligible
- 36.3%
Characteristics of newly eligible adults
- predominantly older women with higher body mass index and borderline glycemic measures but without established cardiovascular disease
Eligibility patterns across racial and ethnic groups
- stable across racial and ethnic groups
Original publication
Shifting Thresholds. JACC Adv. Published 21 January 2026. doi:10.1016/j.jacadv.2025.102546
Summarised from the published abstract; every number is checked against it