Chicago, il at long last, the eighth joint national committee jnc 8 has released its new guidelines on the management of adult. Jnc8 guidelines for the management of hypertension in adults. Pdf jnc 8 hypertension guideline algorithm witri chan. The aha is launching a new initiative that elevates awareness and adoption of ahas 2017 hypertension clinical guidelines. Compared with previous hypertension treatment guidelines, the joint national committee jnc 8 guidelines advise higher blood pressure. 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.
The eighth report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc. Eighth joint national committee jnc8 guidelines and the. Hypothetical jnc 8 recommendations goal bp likely to be refined relaxed for population subgroups, particularly for those 80 and those with dm. Department of health and human services national institutes of health national heart, lung, and blood institute. All the jnc reports have been sponsored by the national institutes of health nih, and hence, had a high degree of visibility and credibility. Jnc 8 guidelines ease up on bp thresholds, drug choices. Hypertension held another successful clinicalpathological conference cpc at the european society of hypertension s annual meeting in 2017.
See the synopsis section for a summary of the updated hypertension treatment recommendations from the eighth joint national committee jnc 8. The new kdigo guidelines for dyslipidaemia treatment increase the indication of statin therapy, especially in patients at high cardiovascular risk. Pdf jnc 8 hypertension guideline algorithm na naha. The seventh report of the joint national committee on. What are the acpaafp and jnc 8 guidelines for initiating.
Uncontrolled high blood pressure bp can lead to heart attack, stroke, heart failure and other serious life threats. 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. Jnc 8 hypertension guideline algorithm lifestyle changes. Patients are categorized according to age and the presence of diabetes dm orand chronic kidney disease. Most people between 9 mmhg sbp or 8089 mmhg dbp will not require medication. Smoking cessation control blood glucose and lipids diet eat healthy i. Lifestyle modifications to manage hypertension modification recommendation sbp reduction weight reduction maintain normal body weight. Worldwide prevalence estimates for htn may be as much as 1 billion.
American college of cardiologyamerican heart association. 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. Explore jnc 8 hypertension guidelines from jama network. Below is a summary of the most recent national guidelines for evaluating these patients, and the figure shows the bp classification by the eighth report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc 8 1 and 2017 american college of cardiologyamerican heart association aha. In contrast, jnc 8 focuses narrowly on drug treatment. 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. Joint national committee jnc guidelines for hypertension. Reference card from the seventh report of the joint. Evaluation, and management of high blood pressure in adults. It is defined as high blood pressure measuring above 14090mm hg in pregnant females without the presence of proteinuria protein casts present in urine and which high blood pressure red. The previous guidelines were known as jnc 7, referring to the seventh iteration of recommendations emanating from a group of bigtime hypertension experts known as the joint national committee jnc.
Recommendations for the management of hypertension recommendation 6 in the general nonblack population, including those with diabetes, initial antihypertensive treatment should include a thiazidetype diuretic, calcium channel blocker ccb, angiotensinconverting enzyme inhibitor acei, or angiotensin receptor blocker arb. Prof alexandre persu brussels presented a case focused on management of hypertension in a pregnant woman with fibromuscular dysplasia and dr marc george london led. Controversy, the jnc8 hypertension guidelines christopher j. In 2014, the eighth joint national committee jnc 8 published the evidencebased guideline for the management of high bp in adults. Recently published hypertension guidelines of the jnc 8. Eighth joint national committee jnc8 guidelines and the outpatient management of hypertension in the africanamerican population. Jnc 8 guidelines for the management of hypertension practice guidelines 504. National high blood pressure education program prevention, detection, evaluation, and treatment of high blood pressure the seventh report of the joint national committee on jnc 7 express u. James pa1, oparil s2, carter bl 1, cushman wc3, dennisonhimmelfarb c4, handler j5.
Jnc 8 new guideline hypertension chart pharmacy exam. 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. 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 started their first. The jnc 7 guidelines were a comprehensive expert consen sus of the prevention, detection, evaluation, and treatment of high blood pressure in adults chobanian 2003, whereas the jnc 8 guidelines were an evidencebased, focused set of recommendations. Updated jnc 8 guidelines for antihypertensive drugs released 2. Hypertension guideline resources american heart association. Betablockers are no longer considered as firstline drugs, according to jnc 8 guidelines for hypertension. While jnc 8 suggests treating patients with both diabetes and hypertension to a blood pressure goal jnc 8 recommendations goal bp likely to be refined relaxed for population subgroups, particularly for those 80 and those with dm. Recently published hypertension guidelines of the jnc 8 panelists. Chlorthalidone recommended over hctz, but preeminence as first line therapy might be challenged. The eighth joint national committee guidelines jnc 8 published in 2014 provides evidence based. Jnc 8 hypertension guideline algorithm initial drugs of. Jnc 8 guidelines for the management of hypertension in adults.
High blood pressure can also have damaging effects to the brain, specifically it can cause an aneurysm or stoke. Jnc 8 report on prevention, evaluation, and treatment of. Jnc 8 and more hypertension guidelines from the eighth joint national committee jnc 8 are finally here. Explore the latest in hypertension, including the epidemiology, prevention, treatment, and longterm outcomes of high blood pressure. The eighth joint national committee guidelines jnc 8. Problem magnitude 35 million office visits are as the primary diagnosis of htn. Appropriately, most of the commentaries in this issue about jnc 8 and the other. Impact of the application of the jnc 8 and kdigo20 guidelines. All individuals with clinical evidence of overt target organ damage table iv or cvd are included in this category, as well as those who have. 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. Reduced role for betablockers as initial therapy still pre eminent for hfref and cad, particularly atenolol. Unlike the jnc 7 guidelines, jnc 8 guidelines do not focus on the definition of hypertension and pre hypertension. Although the nih ultimately withdrew from the guideline development process at a late stage in the development of jnc 8, the panel decided.
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