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. 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. Residual lifetime risk for developing hypertension in middleaged women and men. Jnc 8 hypertension guideline algorithm initial drugs of.
Motion and forces chapter 8 manasquan public schools. Evidencebased guideline for management of high blood pressure in adults report from the panel members appointed to the eighth joint national committee jnc 8 dr arun kochar md. Definition and stages of hypertension according to jnc 7jnc 8. Jnc 8 guidelines were an evidencebased, focused set of rec ommendations. Staying up to date with the jnc 8 hypertension guideline. Dnb senior interventional cardiologist fortis hospital, mohali 2.
The data were so compelling that some members of the jnc 8 panel wanted to keep dbp 55 with stage 12 htn and 1 other chd risk factor. Thiazide diuretics had previously been recommended as monotherapy for patients with stage 1 hypertension or in combination with. Ferdinands opinion about whats to come with respect to jnc 8s hypertension guidelines. Phan, md associate professor of medicine division of.
Patients are categorized according to age and the presence of diabetes dm orand chronic kidney disease ckd. 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 diabetes having a target of less than 14090 mm hg. Tight blood control and risk of macrovascular and microvascular complications in type 2 diabetes. If you are older than 60 years, the new guideline is to treat for a. Update on the therapeutic management of hypertension. Jan 21, 2014 the data were so compelling that some members of the jnc 8 panel wanted to keep dbp jnc 8 recently released evidencebased. Updated jnc 8 guidelines for antihypertensive drugs released. Jnc 7 recommended a treatment threshold of 14090 mm hg regardless of age, whereas jnc 8 raises the systolic threshold at age 60. But since their release has slipped again, what should we do in the meantime. Based on recent guidelines, but not necessarily jnc8, the degree of blood pressure reduction achieved, and not the initial antihypertensive class of agents chosen, is more important for improving cardiovascular outcome in those with hypertension, barry carter, pharmd, of the university of iowa in iowa city, concluded in his talk on. What happens if the sbp is within in the bp goal but dbp is in stage 1 htn. Although the nih ultimately withdrew from the guideline development process at a late stage in the development of jnc 8, the panel decided, nonetheless, to. I have summarized them pretty easily to zip through them.
Report from the panel members appointed to the eighth joint national committee jnc 8 appendix to 2014 evidencebased guideline for the management of high. 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 htn 3 study showed that renal denervation therapy was not more effective than a sham control arm in treating resistant hypertension. Dec 24, 20 jnc 7 recommended a treatment threshold of 14090 mm hg regardless of age, whereas jnc 8 raises the systolic threshold at age 60. Jama guidelines and featured content from jama the journal. Smoking cessation control blood glucose and lipids diet eat healthy i. There have been controversial discussions regarding the most evidencebased blood pressure management guidelines after the release of the eighth joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc 8 guidelines. Jnc 8 hypertension guidelines are scheduled for release in summer 2010. The most significant change in the jnc 8 guideline is relaxation of the. Jnc8 hypertension guidelines 2014 right care initiative. Recommendations 6, 7, and 8 address question 3 concerning selection of antihypertensive drugs. Jnc 8 and more hypertension guidelines from the eighth joint national committee jnc 8 are finally here. The panel members appointed to jnc 8 were selected from more than 400 nominees based on expertise in hypertension n 14, primary care. For patients with stage 1 hypertension whose 10year.
Hypertension guidelines from the eighth joint national committee jnc 8 are finally here. Intensive blood pressure lowering and risk of mortality in chronic kidney disease stages 3 to 5. Guideline comparisons of goal bp and initial drug therapy for adults with hypertension. Jnc is a microsoft certified it and business consulting firm, specialized in data management, business intelligence, and legacy migrations. Jnc 8 update on hypertension guidelines alan cementina, md associate clinical professor. 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. May 30, 2003 for patients age 50 or older, elevated sbp is a stronger cardiovascular risk factor than elevated dbp.
Instead it aims to define thresholds for pharmacological treatment. Supplementary online content james pa, oparil s, carter bl, et al. Unlike the jnc 7 guidelines, jnc 8 guidelines do not focus on the definition of hypertension and pre hypertension. Whats new in hypertension with jnc 8 on the horizon. Eighth joint national committee jnc8 guidelines and the. The eighth joint national committee jnc 8 recently issued the most anticipated guideline in some time. Jnc 8 hypertension guideline algorithm lifestyle changes. George bakris, md, talks to rajiv agarwal, md, about the jnc 8 guidelines and what they are likely to change. Oct 01, 2014 the eighth joint national committee jnc 8 recently issued the most anticipated guideline in some time. More attention is likely to be given to beta blocker selection on the basis of demonstrated cardiovascular outcomes metoprolol, carvedilol in jnc 8. Causes of secondary hypertension with clinical indications and diagnostic. In subsequent years, a series of joint national committee jnc bp guidelines were.
Jnc 8 guidelines for the management of hypertension in adults. Northshore medical group hypertension guidelines target values depend on age and comorbidities a hypertensive patient is considered to be out of control if the. Jnc 8 new guideline hypertension chart pharmacy exam. Report from the panel members appointed to the eighth joint national committee jnc 8 jama. Management in the presence of htn, careful monitoring of blood pressure bp prior to each chemotherapy treatment or more frequently is warranted. For patients age 50 or older, elevated sbp is a stronger cardiovascular risk factor than elevated dbp. Hope substudy likely that nighttime control better in amlodipine group only need to see 46 mmhg. Explore jnc 8 hypertension guidelines from jama network. The eighth joint national committee jnc 8 the new guideline has simpli. Anna esparza, 2nd grade teacher you will receive an extensive resource handbook, specifically designed for this conference. James pa, oparil s, carter bl, cushman wc, dennisonhimmelfarb c, handler j, et al.
In addition, jnc 7 recommended a lower treatment threshold 80 mm hg for patients with diabetes or chronic kidney disease, but jnc 8 does not. Heart failure not included in primary composite predict abpm substudy will yield revealing results e. Keep up to date with clinical guidelines, original research articles, videos, and webinars from jama and jama network specialty journals. Pdf staying up to date with the jnc 8 hypertension guideline. Recommendations 1 through 5 address questions 1 and 2 concerning thresholds and goals for bp treatment. As a primary care physician i found it very useful to hear dr. Tight blood control and risk of macrovascular and microvascular complications in type 2 diabetes 1148 patients randomized to tight control or less tight control tight control defined as htn 3 study showed that renal denervation therapy was not more effective than a sham control arm in treating resistant hypertension.
Stage 1 hypertension 140159 9099 stage 2 hypertension. Association of jnc 8 and sprint systolic blood pressure levels with cognitive function and related racial disparity. Compared with previous hypertension treatment guidelines, the joint national committee jnc 8 guidelines advise higher blood pressure. Within the bp range of 11575 mm hg to 185115 mm hg, each increment of 2010 mm hg doubles cardiovascular risk. In addition to higher prevalence, this population has experienced a much lower awareness of hypertension, affecting control of resultant comorbidities such as stroke, coronary heart disease, and chronic renal failure. Phan, md associate professor of medicine division of cardiology san francisco general hospital. We offer strategic analysis and custom software that streamline complex operations and meet business goals. Jnc 8 only answers a few new questions for the primary care physician, mostly focused on hypertension treatment recommendations. Reference card from the seventh report of the joint national. Individualswho are normotensive at 55 years have a 90% likelihood of developinghigh blood pressure during the next 25 years vasan rs, beiser a, seshadri s, et al. In the general population, pharmacologic treatment should be initiated when blood pressure is 15090 mm hg or higher in adults 60 years and older, or 14090 mm hg or higher in adults younger than 60 years. Guidelines for management of high blood pressure in adults. The joint national commission issued updated hypertension guidelines in december 20 based on more rigorous evidence, and less dependence on expert opinion, than jnc 7. Update on the therapeutic management of hypertension baseline knowledge statements readers of this chapter are presumed to be familiar with the following.
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