Media Coverage of the Benefits and Harms of the 2017 Expanded Definition of High Blood Pressure

Expanding disease definitions are one driver of overdiagnosis and related overtreatment.1 In November 2017, new guidelines from the American College of Cardiology and the American Heart Association (ACC/AHA) expanded the definition of hypertension, extending the label to 46% of adults in the United States.2 The expanded definition was welcomed by some as an important public health initiative; however, other national and international groups, including the American Academy of Family Physicians, did not endorse the expanded definition amid concerns about potential harms.3 Concerns raised included potential overtreatment; intellectual conflicts of interest held by some of the panel members involved with the new ACC/AHA guideline, including members who were connected to a major trial that strongly influenced the guideline; and uncertainty regarding blood pressure measurement methods. A checklist-based analysis found that most people newly classified as hypertensive were unlikely to benefit, but instead could experience harms from being unnecessarily labeled as having hypertension, and some people could experience adverse effects from unnecessary medication.4 We investigated how the media covered the potential benefits and harms of the expanded definition of hypertension.