Betablockers are no longer considered as firstline drugs, according to jnc 8 guidelines for hypertension. Evaluation, and management of high blood pressure in adults. Hypertension or high blood pressure can lead to heart disease, stroke, and death and is a major global health concern. While treatment targets may differ among various guidelines, it is important to keep evaluation of. Problem magnitude 35 million office visits are as the primary diagnosis of htn. Jnc 8 new guideline hypertension chart pharmacy exam. Northshore medical group hypertension guidelines target values depend on age and comorbidities a hypertensive patient is considered to be out of control if the following bp reading is above target. Evidencebased guideline for the management of high blood pressure in adults. In contrast, the hypertension guideline from the 8th joint national committee jnc 8 defines hypertension as bp of 14090 mmhg or above an ongoing controversy. American college of cardiologyamerican heart association. Stage3 hypertension a severely elevated blood pressure, a bp number over 180110 mmhg is considering as stage3 hypertension. The seventh report of the joint national committee on. Jnc8 hypertension management guidelines and those who were treated with other regimens. In the united states alone, more than 65 million individuals have hypertension.
In 2003, the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc issued its seventh report, which provided guidelines for the diagnosis and management of this disease. Report from the panel members appointed to the eighth joint national committee jnc 8. Comparison between jnc 7 and jnc 8 jnc 7 blood pressure classification7 blood pressure systolic blood pressure mmhg diastolic blood pressure mmhg normal stage 1 hypertension 140159 or 9099 stage 2 hypertension 160 or 100. The sprint trial systolic blood pressure intervention trial. Reference card from the seventh report of the joint national. Jnc vii bp classification blood pressure classification sbp mm hg dbp mm hg normal prehypertension 1209 8089 stage i hypertension 140159 9099 stage ii hypertension. 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. Jun 01, 2015 in 2014, the eighth joint national committee jnc 8 published the evidencebased guideline for the management of high bp in adults. Most people between 9 mmhg sbp or 8089 mmhg dbp will not require medication.
Hypertension is second only to diabetes as the most common antecedent for this. It is an early form of high blood pressure considering as mild and need medical treatment with bp monitoring on every doctors visit. In 2018 the escesh published a guideline which retains the 14090 threshold definition of hypertension, including for patients with chronic kidney disease ckd. Association of jnc 8 and sprint systolic blood pressure levels with cognitive function and related racial disparity.
Explore jnc 8 hypertension guidelines from jama network. While jnc 8 suggests treating patients with both diabetes and hypertension to a blood pressure goal 14090 mmhg. Instead, the jnc 8 guidelines encourage use of agents with the best evidence of reducing cardiovascular risk. Types of hypertension and complications major types of. Treatment of high blood pressure jnc 7 was based on 4 factors. Moreover, there is an increasing trend in end stage renal disease esrd by primary diagnosis.
Guidelines for management of high blood pressure 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 jnc7 stage 2 hypertension and the resting heart rate faster than 80 group, the highest hazard ratios were for cardiovascular mortality 4. Jnc 8 hypertension guideline algorithm initial drugs of. Unlike the jnc 7 guidelines, jnc 8 guidelines do not focus on the definition of hypertension and pre hypertension. Learn vocabulary, terms, and more with flashcards, games, and other study tools. 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 end stage renal disease. Major types of hypertension high blood pressure primary hypertension, also known as essential hypertension, is the most common type of hypertension.
Worldwide prevalence estimates for htn may be as much as 1 billion. Jnc 8 bp target of 80 yrs hypertension in the very elderly trial. In addition, roughly half of hypertensive individuals do not have adequate blood pressure control. Reference card from the seventh report of the joint.
Instead it aims to define thresholds for pharmacological treatment. 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. Jnc 7, the predecessor of this guideline, was a comprehensive document that covered not only hypertension treatment, but also definitions of hypertension, issues in bp measurement, public health perspectives, lifestyle modification, and special situations in hypertension management. Jnc8 guidelines for the management of hypertension in adults. Updated jnc 8 guidelines for antihypertensive drugs released.
Jnc 8 update on hypertension guidelines alan cementina, md associate clinical professor family medicine center at asylum hill. Blood pressure and cholesterol embracing new guidelines association of jnc 8 and sprint systolic blood pressure levels. This page includes the following topics and synonyms. The 2017 guideline on management of high blood pressure in adults. Goal for all patients the jnc8 hypertension guidelines christopher j. Hypertension guidelines european heart journal oxford. Prevalence of hypertension, treatment, and blood pressure targets in canada associated with the 2017 american college of cardiology and american heart association blood pressure guidelines. Intensive blood pressure lowering and risk of mortality in chronic kidney disease stages 3 to 5. However, the updated jnc8 guidelines do not include beta. This applies to all ckd patients with hypertension regardless of race or diabetes status. The 2019 certification examinations use the 2017 accaha and jnc 8 guidelines to reference test items.
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. While jnc 8 suggests treating patients with both diabetes and hypertension to a blood pressure goal northshore medical group hypertension guidelines target values depend on age and comorbidities a hypertensive patient is considered to be out of control if the following bp reading is above target. Jnc 8 report on prevention, evaluation, and treatment of. Apr 01, 2014 see the synopsis section for a summary of the updated hypertension treatment recommendations from the eighth joint national committee jnc 8. Smoking cessation control blood glucose and lipids diet eat healthy i. For this type of hypertension, there is no single identifiable cause. Association of resting heart rate and hypertension stages on. It is the third stage of hypertension considering as severe and needs urgent stringent medical treatment with more frequent monitoring to avoid any hypertension complication. The eighth joint national committee guidelines jnc 8 published in 2014 provides evidence based. Hypertension risk stratification, hypertension risk group a, hypertension risk group b, hypertension. Hypertension, also known as high blood pressure, affects hundreds of millions of persons worldwide. Pdf jnc 8 hypertension guideline algorithm witri chan. Jnc 8 guidelines and stepwise approach to the treatment of.
Jama network open original investigation, march 8, 2019. Although this was a controversial publication, the intent of the jnc 8 committee was to bridge the gap between jnc 7 and the new accaha guidelines that were in development, given that jnc 7 was published in 2003 and many believed it to be outdated. Although the nih ultimately withdrew from the guideline development process at a late stage in the development of jnc 8, the panel decided. Those with stage 1 hypertension whose estimated risk is 10% or more should receive bplowering therapy in conjunction with nonpharmacologic interventions, then undergo repeat evaluation in.
The jnc 7 panel recommended that after an initial high blood pressure reading, followup with a confirmatory blood pressure reading should occur within 7 days to 2 months, depending on how high the initial reading was and whether or not the patient had kidney disease or endorgan damage as a result of hypertension. Start studying jnc 8 guidelines and stepwise approach to the treatment of htn. While we were waiting for jnc 8, the american society. The global prevalence of hypertension is high, and among nonpregnant adults in the united states, treatment of hypertension is the most common reason for office visits and for the use of chronic prescription medications. Compared with previous hypertension treatment guidelines, the joint national committee jnc 8 guidelines advise. High blood pressure should be treated earlier with lifestyle changes and in some patients with medication at 80 mm hg rather than 14090 based on new acc and american heart association aha guidelines for the detection, prevention, management and treatment of high blood pressure. Compared with previous hypertension treatment guidelines, the joint national committee jnc 8 guidelines advise higher blood pressure. Patients will be asking about the new jnc 8 hypertension guidelines. The lowest recorded bp at the most recent a office visit with internal medicine, family medicine, endocrinology, cardiology, and nephrology or. Dec 05, 2017 this jama clinical guidelines synopsis summarizes the 2017 american college of cardiologyamerican heart association guideline on prevention, detection, evaluation, and management of high blood pressure in adults.
Pdf eighth joint national committee jnc8 guidelines and the. The association seemed to be stronger in the jnc8 hypertension groups. Nov 08, 2001 jnc 8 update on hypertension guidelines alan cementina md associate clinical professor family medicine center at asylum hill. High blood pressure, if left untreated, can cause severe damage to the bodys organs. 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 recommends thresholds for treatment of high blood pressure, blood pressure goals, and evidencebased medication therapy. 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. Explore the latest in hypertension, including the epidemiology, prevention, treatment, and longterm outcomes of high blood pressure. Patients are categorized according to age and the presence of diabetes dm orand chronic kidney disease ckd. Hypertension guidelines from the eighth joint national committee jnc 8 are finally here. Joint national committee 8 jnc 8 guidelines for management. Over 50 million americans have high blood pressure. Algorithm for treatment of hypertension reference card from the 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 recently released evidencebased. Normal 80 prehypertension 1209 or 8089 hypertension, stage 1 140 159 or 9099 hypertension, stage 2. In contrast, jnc 8 focuses narrowly on drug treatment.
Jnc 8 guidelines for the management of hypertension in adults. James pa, oparil s, carter bl, cushman wc, dennisonhimmelfarb c, handler j, et al. Detection, evaluation, and treatment of high blood pressure jnc 6 was released in 1997, new knowledge has come to light from a variety of sources. Stage 1 hypertension a mildly elevated blood pressure, a bp number between 14090 to 15999 mmhg is considering as stage 1 hypertension. Secondly, similar treatment goals have been defined for all hypertensive population and no distinction between uncomplicated hypertension and hypertension with comorbid conditions like diabetes or chronic kidney. 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. Firstly, the definitions of hypertension and prehypertension, which were welldefined in jnc 7 has not been addressed in jnc 8. Joint national committee jnc guidelines for hypertension. There is no apparent underlying disease, condition or disorder. Jnc 8 hypertension guidelines acp arizona chapter annual meeting 2014 shakaib rehman, md, sch, facp, faach associate chief of staff for education phoenix va healthcare systems professor of medicine professor of biomedical informatics university of arizona college of medicinephoenix. 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. 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. Jnc 8 and more hypertension guidelines from the eighth joint national committee jnc 8 are finally here.
Recommendations for the management of hypertension recommendation 1 in the general population aged. 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 7 suggests that all people with hypertension stages 1 and 2. Jnc 8 hypertension guideline algorithm lifestyle changes. The eighth joint national committee jnc 8 the new guideline has simpli. Pdf on jan 1, 2014, michael r page and others published the jnc 8 hypertension guidelines. The eighth joint national committee guidelines jnc 8. Detection, evaluation, and treatment of high blood.