Patients will be asking about the new joint national committee jnc 8 hypertension guidelines, which were published in the journal of the american medical association on december 18. Each stage of hypertension is characterized by the cumu. Eighth joint national committee jnc8 guidelines and the. Jnc 8 hypertension guideline algorithm initial drugs of. Strong recommendation grade a high certainty based on evidence that net benefit is substantial. Hypertension is a major independent risk factor for coronary artery disease, stroke, heart failure, and renal failure.
Worldwide prevalence estimates for htn may be as much as 1 billion. May 30, 2003 using jnc 7 as a point of departure, an editorialist argues that hypertension control will improve only with substantial changes in the delivery of chronicdisease care and in how the public views lifestyle changes. Our study compared the target blood pressure goals and frequency of endorgan damage in adult africanamerican patients who were in compliance with the new jnc 8 hypertension management guidelines compared those managed with antihypertensive medications other than a ccb andor a thiazidetype diuretic. Two blood pressure measurements six hours apart of greater than 14090 mm hg are diagnostic of hypertension in pregnancy. Based on its recommendations, the classification of blood pressure, which is the average of two or more readings each taken at two or more visits after initial. Individuals are either normal or hypertensive based on their cv status. Hypertension affects onethird of americans and is a significant modifiable risk factor for cardiovascular disease, stroke, renal disease, and death. Jnc 7 stage 2 hypertension usually have sustained resting bp levels 140. Recently published hypertension guidelines of the jnc 8 panelists.
Patients are categorized according to age and the presence of diabetes dm orand chronic kidney disease ckd. Using jnc 7 as a point of departure, an editorialist argues that hypertension control will improve only with substantial changes in the delivery of chronicdisease care and in how the public views lifestyle changes. Hypertension is an easily diagnosed and potentially easily treated problem. Compared with previous hypertension treatment guidelines, the joint national committee jnc 8 guidelines advise higher blood pressure goals and less use of several types of antihypertensive medications.
Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc 7 evaluation classification of blood pressure bp category sbp mmhg dbp mmhg normal jnc 8 guidelines on htn, evidence from clinical trials indicate that antihypertensive medications blood pressure medication should be initiated in patients less than 60 years old if the systolic blood pressure is persistently 140 mmhg and the diastolic blood. Hypertension is one of the most common conditions seen in primary care and optimal management of hypertension is an important intervention in prevention of stroke, myocardial infarction, renal failure and death. The ahaacc guidelines define it as a blood pressure of. Although severe hypertension is identified and managed in a specialist care setting, considerable percentage of indians have stagei hypertension by any definition. Hypertension is defined as a systolic blood pressure sbp of 140 mm hg or more, or a diastolic blood pressure dbp of 90 mm hg or more, or taking antihypertensive medication. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Jnc 8 panel members guideline was published in the journal of the american medical association, it was without the support of any sponsoring organization. Jnc 8 hypertension guideline algorithm lifestyle changes. Jnc 8 guidelines were an evidencebased, focused set of rec.
The guidelines were created after a committee of experts synthesized all available scientific evidence, and they were updated to provide guidance for doctors for the management of hypertension. Joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension accounts for 18% of cardiovascular disease deaths in. The progression of hypertensionfrom early to advancedmay be represented as stages 1, 2, and 3 hypertension. The new guidelines also introduce new recommendations. The new guidelines emphasize control of systolic blood pressure sbp and diastolic blood pressure dbp with age and comorbidityspecific treatment cutoffs. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure iii chair aram v. Betablockers are no longer considered as firstline drugs, according to jnc 8 guidelines for hypertension. Hypertension is described as the most important modifiable risk factor for coronary heart disease leading cause of death in the united states, stroke third leading cause, congestive heart failure, and endstage renal disease. In 2014, the eighth joint national committee jnc 8 published the evidencebased guideline for the management of high bp in adults. The jnc 8 guidelines move away from the assumption that lower blood pressure levels will improve outcomes regardless of the type of agent used to achieve the lower level. In the report from the panel members appointed to the eighth joint national committee jnc 8, the guideline authors provide evidencebased recommendations for the management of hypertension including specific goals by age, race, and comorbidities.
While we were waiting for jnc 8, the american society of hypertension ash in collaboration with the international society of hypertension released their own expert opinion piece aimed at prescribers. Jnc 8 bp target of 80 yrs hypertension in the very elderly trial. Normal bp is accepted as detection, evaluation, and management of high blood pressure in adults bp 5 back to table of contents of. Smoking cessation control blood glucose and lipids diet eat healthy i. Hypertension rarely causes symptoms in the early stages and many people go undiagnosed. The last report on management guidelines of hypertension was released in 2003. What is the definition of hypertension high blood pressure.
Updated hypertension recommendations from panel members previously appointed to the eight joint national committee jnc 8 raised blood pressure goals in adults age 60 and older to less than 15090 mm hg, with patients younger than 60 years old including those with chronic kidney disease and. More than 2 decades have passed since the publication of the jnc 7 guidelines. Compared with previous hypertension treatment guidelines, the joint national committee jnc 8 guidelines advise higher blood pressure. Hypertension guidelines from the eighth joint national committee jnc 8 are finally. The eighth joint national committee jnc 8 the new guideline has simpli. Also see our pl algorithm, stepwise approach to hypertension treatment. There are significant health and economic gains attached to early detection, adequate treatment and good control of. That partnership fell through as well, so when the jnc 8 panel members guideline was published in the journal of the american medical association, it. Chlorthalidone recommended over hctz, but preeminence as first line therapy might be challenged. American college of cardiologyamerican heart association whelton pk et al, jacc 71. Jnc 8 recommends thresholds for treatment of high blood pressure, blood pressure goals, and evidencebased medication therapy.
Jnc 8 new guideline hypertension chart pharmacy exam. Those who are diagnosed may not have access to treatment and may not be able to successfully control their illness over the long term. Most people between 9 mmhg sbp or 8089 mmhg dbp will not require medication. Instead, the jnc 8 guidelines encourage use of agents with the best evidence of reducing cardiovascular risk. Hypertension is a common condition that affects one in every three adults in the united states. Hypertension in western pacific world health organization. Jnc 8 guidelines for the management of hypertension in adults. High blood pressure in pregnancy can be classified as preexisting hypertension, gestational hypertension, or preeclampsia. Preeclampsia is a serious condition of the second half of pregnancy and following. In 2014, the eighth joint national committee jnc 8 published the.
Reference card from the seventh report of the joint. Recent guidelines for hypertension circulation research. In 2018 the escesh published a guideline which retains the 14090 threshold definition of hypertension, including for patients with chronic kidney disease ckd, and emphasizes lifestyle interventions as primary treatment, with consideration of antihypertensive drug therapy only in adults at very high risk, eg with established cvd. Jun 01, 2015 in 2014, the eighth joint national committee jnc 8 published the evidencebased guideline for the management of high bp in adults. The eighth joint national committee guidelines jnc 8 published in 2014 provides evidence based. A large number of indians have prehypertension, which embraces the new stagei hypertension per american guidelines. However, the updated jnc8 guidelines do not include beta blockers as initial. A paper was published in the journal of the american medical association in 2014 that is generally referred to as jnc 8 but officially, there are no jnc 8 guidelines sanctioned by the nhlbi, nor has jnc 8 been endorsed by the aha, acc, or many other organizations that endorsed jnc7. Definition a systolic blood pressure sbp 9 mmhg andor a diastolic dbp 89 mmhg. Hypertension update, jnc8 and beyond pharmacology and. Hypertension occurs in approximately 810% of pregnancies. The sprint trial systolic blood pressure intervention trial n engl j med 373.
Staging of hypertension and total cv risk assessment are related but not identical. Our study compared the target blood pressure goals and frequency of endorgan damage in adult africanamerican patients who were in compliance with the new jnc8 hypertension management guidelines compared those managed with antihypertensive medications other. Betablockers are no longer considered as firstline drugs, according to jnc 8. Hypertension is the sustained elevation of systemic arterial blood pressure. Hypothetical jnc 8 recommendations goal bp likely to be refined relaxed for population subgroups, particularly for those 80 and those with dm. Jnc 8 update on hypertension guidelines alan cementina, md associate clinical professor family medicine center at asylum hill. Although the nih ultimately withdrew from the guideline development process at a late stage in the development of jnc 8, the panel decided. Dash diet dietary approaches to stop hypertension as effective as one medication jnc 7 summary joint national commission 7th report pdf file on website 50 page document other jnc 7 resources software for use with palm and pocket pc jnc 7 reference card other resources chronic kidney disease information gfr calculator. Normal bp is accepted as jnc released htn guidelines, most recently jnc 8 in 2014. The primary intention of jnc 8 was to put forward strict evidencebased recommenda tions focusing on thresholds for defining and treating hypertension and. Guidelines for management of high blood pressure in adults. Hypertension can be classified as either primary essential or secondary. Jnc 8 and more hypertension guidelines from the eighth joint national committee jnc 8 are finally here.
Pdf on jan 1, 2014, michael r page and others published the jnc 8 hypertension guidelines. Average awake blood pressure 585 and asleep blood pressure 12075 on 24 hr blood pressure monitoring. Compared with previous hypertension treatment guidelines, the joint national committee jnc 8 guidelines advise. One of every 3 american adultsor approximately 67 million adults 31%has hypertension htn. And if you add to this prodigious number, the previous category of prehypertension, the absolute numbers of people at risk is. Reduced role for betablockers as initial therapy still pre eminent for hfref and cad, particularly atenolol. Joint national committee 8 jnc 8 guidelines for management. Based on the average of two or more properly measured, seated bp readings. Definition of hypertension hypertension is a progressive cv syndrome arising from complex and interrelated etiologies. The eighth joint national committee guidelines jnc 8.
1060 540 914 1264 500 1537 962 42 780 1626 597 257 959 409 270 578 796 318 933 1230 871 800 1545 1204 1357 1568 250 1642 621 248 1027 471 1478 1169 289 1106