{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T01:34:44Z","timestamp":1749519284870,"version":"3.37.3"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"4","funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The 2017 American College of Cardiology \/ American Heart Association Guideline for blood pressure (BP) management newly classifies millions of Americans with elevated BP or stage 1 hypertension for recommended lifestyle modification alone (without pharmacotherapy). This study characterized these adults, including their cardiovascular disease risk factors, barriers to lifestyle modification, and healthcare access.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This cross-sectional study examined nationally representative National Health and Nutrition Examination Survey data, 2013\u20132016, on 10,205 US adults aged \u226518, among whom 2,081 had elevated BP or stage 1 hypertension and met 2017 ACC\/AHA BP Guideline criteria for lifestyle modification alone.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>An estimated 22% of US adults (52 million) would be recommended for lifestyle modification alone. Among these, 58% were men, 43% had obesity, 52% had low-quality diet, 95% consumed excess sodium, 43% were physically inactive, and 8% consumed excess alcohol. Many reported attempting lifestyle changes (range: 39%\u201360%). Those who reported receiving health professional advice to lose weight (adjusted prevalence ratio 1.21, 95% confidence interval 1.06\u20131.38), reduce sodium intake (2.33, 2.00\u20132.72), or exercise more (1.60, 1.32\u20131.95) were significantly more likely to report attempting changes. However, potential barriers to lifestyle modification included 28% of adults reporting disability, asthma, or arthritis. Additionally, 20% had no health insurance and 22% had no healthcare visits in the last year.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>One-fifth of US adults met 2017 ACC\/AHA BP Guideline criteria for lifestyle modification alone, and many reported attempting behavior change. However, barriers exist such as insurance gaps, limited access to care, and physical impairment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpaa173","type":"journal-article","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T20:12:40Z","timestamp":1603829560000},"page":"348-358","source":"Crossref","is-referenced-by-count":5,"title":["Characteristics of US Adults Who Would Be Recommended for Lifestyle Modification Without Antihypertensive Medication to Manage Blood Pressure"],"prefix":"10.1093","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4810-0572","authenticated-orcid":false,"given":"Sandra L","family":"Jackson","sequence":"first","affiliation":[{"name":"Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soyoun","family":"Park","sequence":"additional","affiliation":[{"name":"Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fleetwood","family":"Loustalot","sequence":"additional","affiliation":[{"name":"U.S. Public Health Service, Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela M","family":"Thompson-Paul","sequence":"additional","affiliation":[{"name":"U.S. Public Health Service, Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuling","family":"Hong","sequence":"additional","affiliation":[{"name":"Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew D","family":"Ritchey","sequence":"additional","affiliation":[{"name":"U.S. Public Health Service, Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,10,29]]},"reference":[{"key":"2021063011172779900_CIT0001","first-page":"2017","article-title":"Underlying Cause of Death 1999-2015 on CDC Wonder Online Database, Released December","volume":"2016","author":"Centers for Disease Control and Prevention, National Center for Health Statistics","year":"1999","journal-title":"Data Are from the Multiple Cause of Death Files"},{"key":"2021063011172779900_CIT0002","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1161\/CIRCULATIONAHA.118.035640","article-title":"Potential cardiovascular disease events prevented with adoption of the 2017 American College of Cardiology\/American Heart Association Blood Pressure Guideline","volume":"139","author":"Bress","year":"2019","journal-title":"Circulation"},{"key":"2021063011172779900_CIT0003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta7310","article-title":"Lowering blood pressure to prevent myocardial infarction and stroke: a new preventive strategy","volume":"7","author":"Law","year":"2003","journal-title":"Health Technol Assess"},{"key":"2021063011172779900_CIT0004","first-page":"e13","article-title":"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","volume-title":"A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines. 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