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CLINICAL STATEMENTS AND GUIDELINES

Circulation. 2025;152:e114–e218. DOI: 10.1161/CIR.0000000000001356 September 16, 2025 e189

2 Rapsomaniki E, Timmis A, George J, et al. Blood pressure and incidence

of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million people. Lancet. 2014;383:1899– 1911. 3.	 Whelton SP, McEvoy JW, Shaw L, et al. Association of normal systolic blood pressure level with cardiovascular disease in the absence of risk factors. JAMA Cardiol. 2020;5:1011–1018. 4.	 Fuchs SC, Poli-de-Figueiredo CE, Figueiredo Neto JA, et al. Effective­ ness of chlorthalidone plus amiloride for the prevention of hypertension: the PREVER-Prevention randomized clinical trial. J Am Heart Assoc. 2016;5:e004248. 5.	 Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/

ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71:1269– 1324.

3 Evaluation and Diagnosis

1 Global Burden Disease Risk Factors Collaborators. Global burden of 87 risk

factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396:1223– 1249. 2.	 Forouzanfar MH, Liu P, Roth GA, et al. Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg, 1990-2015. JAMA. 2017;317:165–182. 3.	 Martin SS, Aday AW, Almarzooq ZI, et al. 2024 heart disease and stroke statistics: a report of US and global data from the American Heart Associa­ tion. Circulation. 2024;149:e347-e913. 4.	 Franklin SS, Gustin Wt, Wong ND, et al. Hemodynamic patterns of agerelated changes in blood pressure. The Framingham Heart Study. Circulation. 1997;96:308–315. 5.	 Chen V, Ning H, Allen N, et al. Lifetime risks for hypertension by contem­ porary guidelines in African American and White men and women. JAMA Cardiol. 2019;4:455–459. 6.	 Carson AP, Howard G, Burke GL, et al. Ethnic differences in hypertension incidence among middle-aged and older adults: the multi-ethnic study of atherosclerosis. Hypertension. 2011;57:1101–1107. 7.	 Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for develop­ ing hypertension in middle-aged women and men: the Framingham Heart Study. JAMA. 2002;287:1003–1010. 8.	 Lloyd-Jones DM, Evans JC, Larson MG, et al. Cross-classification of JNC VI blood pressure stages and risk groups in the Framingham Heart Study. Arch Intern Med. 1999;159:2206–2212. 9.	 Jaeger BC, Chen L, Foti K, et al. Hypertension statistics for US adults: an open-source web application for analysis and visualization of National Health and Nutrition Examination Survey data. Hypertension. 2023;80:1311–1320. 10.	 Khan SS, Coresh J, Pencina MJ, et al. Novel prediction equations for absolute risk assessment of total cardiovascular disease incorporating cardiovascular-kidney-metabolic health: a scientific statement from the American Heart Association. Circulation. 2023;148:1982–2004. 11.	 Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903–1913. 12.	 Whelton SP, McEvoy JW, Shaw L, et al. Association of normal systolic blood pressure level with cardiovascular disease in the absence of risk factors. JAMA Cardiol. 2020;5:1011–1018. 13.	 Rapsomaniki E, Timmis A, George J, et al. Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million people. Lancet. 2014;383:1899– 1911. 14.	 Weldegiorgis M, Woodward M. The impact of hypertension on chronic kid­ ney disease and end-stage renal disease is greater in men than women: a systematic review and meta-analysis. BMC Nephrol. 2020;21:506. 15.	 Garofalo C, Borrelli S, Pacilio M, et al. Hypertension and prehyperten­ sion and prediction of development of decreased estimated GFR in the general population: a meta-analysis of cohort studies. Am J Kidney Dis. 2016;67:89–97. 16.	 Yaffe K, Vittinghoff E, Pletcher MJ, et al. Early adult to midlife cardiovascular risk factors and cognitive function. Circulation. 2014;129:1560–1567. 17.	 Liu K, Colangelo LA, Daviglus ML, et al. Can antihypertensive treatment re­

store the risk of cardiovascular disease to ideal levels? The Coronary Artery Risk Development in Young Adults (CARDIA) study and the Multi-Ethnic Study of Atherosclerosis (MESA). J Am Heart Assoc. 2015;4:e002275. 18 Lieb W, Enserro DM, Sullivan LM, et al. Residual cardiovascular risk in

individuals on blood pressure-lowering treatment. J Am Heart Assoc. 2015;4:e002155. 19.	 Khan SS, Coresh J, Pencina MJ, et al. Novel prediction equations for absolute risk assessment of total cardiovascular disease incorporating cardiovascular-kidney-metabolic health: a scientific statement from the American Heart Association. Circulation. 2023;148:1982–2004. 20.	 Khan SS, Matsushita K, Sang Y, et al. Development and validation of

the American Heart Association's PREVENT equations. Circulation. 2024;149:430–449.

3.1.1 Accurate Measurement of In-Office BP

1 Giorgini P, Weder AB, Jackson EA, et al. A review of blood pressure mea­

surement protocols among hypertension trials: implications for “evidencebased” clinical practice. J Am Soc Hypertens. 2014;8:670–676. 2.	 Kallioinen N, Hill A, Horswill MS, et al. Sources of inaccuracy in the mea­ surement of adult patients' resting blood pressure in clinical settings: a sys­ tematic review. J Hypertens. 2017;35:421–441. 3.	 Liu J, Li Y, Li J, et al. Sources of automatic office blood pressure mea­ surement error: a systematic review. Physiol Meas. 2022;43(9). doi: 10.1088/1361-6579/ac890e. 4.	 Cohen JB, Padwal RS, Gutkin M, et al. History and justification of a na­ tional blood pressure measurement validated device listing. Hypertension. 2019;73:258–264. 5.	 Muntner P, Shimbo D, Carey RM, et al. Measurement of blood pressure in humans: a scientific statement from the American Heart Association. Hy­ pertension. 2019;73:e35-e66. 6.	 Roerecke M, Kaczorowski J, Myers MG. Comparing automated office blood pressure readings with other methods of blood pressure measurement for identifying patients with possible hypertension: a systematic review and meta-analysis. JAMA Intern Med. 2019;179:351–362. 7.	 Ishigami J, Charleston J, Miller ER 3rd, et al. Effects of cuff size on the ac­ curacy of blood pressure readings: the Cuff(SZ) randomized crossover trial. JAMA Intern Med. 2023;183:1061–1068. 8.	 Muntner P, Einhorn PT, Cushman WC, et al. Blood pressure assessment in adults in clinical practice and clinic-based research: JACC scientific expert panel. J Am Coll Cardiol. 2019;73:317–335. 9.	 American Medical Association. Blood Pressure Devices (US Blood Pres­ sure Validated Device Listing). Accessed October 17, 2024. https://www. validatebp.org/. 10.	 Powers BJ, Olsen MK, Smith VA, et al. Measuring blood pressure for deci­ sion making and quality reporting: where and how many measures? Ann Intern Med. 2011;154:781–788, W-289–790. 11.	 Kronish IM, Edmondson D, Shimbo D, et al. A comparison of the diagnostic accuracy of common office blood pressure measurement protocols. Am J Hypertens. 2018;31:827–834. 12.	 Hayer R, Kirley K, Cohen JB, et al. Using web-based training to improve accuracy of blood pressure measurement among health care professionals: a randomized trial. J Clin Hypertens (Greenwich). 2022;24:255–262. 13.	 Picone DS, Deshpande RA, Schultz MG, et al. Nonvalidated home blood pressure devices dominate the online marketplace in Australia: major impli­ cations for cardiovascular risk management. Hypertension. 2020;75:1593– 1599. 14.	 National Health and Nutrition Examination Survey. Blood pressure pro­ cedures manual. Centers for Disease Control and Prevention. Updated June 2019. Accessed May, 2024. https://wwwn.cdc.gov/nchs/data/ nhanes/2019-2020/manuals/2019-Blood-Pressure-Procedures-Manu­ al-508.pdf. 15.	 Stergiou GS, Kyriakoulis KG, Stambolliu E, et al. Blood pressure measure­ ment in atrial fibrillation: review and meta-analysis of evidence on accuracy and clinical relevance. J Hypertens. 2019;37:2430–2441. 16.	 Fonseca-Reyes S, Fonseca-Cortes K, Coca A, et al. Conventional office blood pressure measurements and unattended automated office blood pressure compared with home self-measurement and 24-h ambulatory blood pressure monitoring. Blood Press Monit. 2023;28:59–66. 17.	 Bauer F, Seibert FS, Rohn B, et al. Attended versus unattended blood pres­ sure measurement in a real life setting. Hypertension. 2018;71:243–249. 18.	 Green BB, Anderson ML, Cook AJ, et al. Automated office blood pressure and the impact of attendance and rest on diagnostic accuracy. Am J Hyper­ tens. 2022;35:638–646. 19.	 Kollias A, Stambolliu E, Kyriakoulis KG, et al. Unattended versus attended

automated office blood pressure: systematic review and meta-analysis of studies using the same methodology for both methods. J Clin Hypertens (Greenwich). 2019;21:148–155.

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