Jnc 8 guidelines for the management of hypertension in adults author. What is essentialprimary hypertension htn with no identifiable cause. Jnc 8 only answers a few new questions for the primary care physician, mostly focused on hypertension treatment recommendations. Mar 01, 2012 jnc 7 show series solution based strategies for addressing multidisciplinary issues in hypertension. Whats changed jnc uses randomized trials, and is explicit when a recommendation reflects only expert opinion.
The change to a more lenient systolic blood pressure goal may be confusing to many patients who are accustomed to the lower goals of jnc 7. Numerous evidencedbased interventions are available to prevent high blood pressure and improve high blood pressure. Boston university school of medicine, boston, ma executive committee george l. In addition to preventing or reducing high blood pressure, these modi. Meets criteria for htn results from an identifiable, potentially correctable cause accounts for significant number of resistantaccounts for significant number of resistant htn cases estimated to account for 515% of cases of htn prevalence of hypertension in adults between 2030% 5070 million people.
What is hypertension jnc 7 what is hypertension for childrenadolescents. Hypertension 1 update, jnc8 and beyond tara shrout, david w rudy2 and michael t piascik3 hypertension is the most preventable major risk factor for cardiovascular morbidity and mortality. Americans have high blood pressure bp warranting some form of treatment. Installation instructions and download of hypertension guideline application jnc 7 for palm os and pocketpc 2003. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure iii chair aram v. Hypertension is an easily diagnosed and potentially easily treated problem.
The jnc8 guidelines differ from the jnc 7 guidelines in two key areas. Nov, 2017 2017 hypertension clinical practice guidelines released. Average sbpdbp 95th percentile for age, gender, and height. Jnc 8 uses 14090 for patients with diabetes or chronic kidney disease. Jnc7 show series solution based strategies for addressing multidisciplinary issues in hypertension. Patients are categorized according to age and the presence of diabetes dm orand chronic kidney disease ckd. Openclinical clinical applications jnc 7 hypertension.
The lowest recorded bp at the most recent a office visit with internal medicine, family medicine, endocrinology, cardiology, and nephrology or. Jnc 7 suggests that all people with hypertension stages 1 and 2 be treated. Chicago, il new national guidelines, known as the seventh report of. Abundant evidence from randomized controlled trials rcts has shown benefit of antihypertensive drug treatment in reducing important health outcomes in persons with hypertension. Use of jnc 7 high blood pressure tool is restricted to health professionals. Chicago, il at long last, the eighth joint national committee jnc 8 has released its new guidelines on the management of adult hypertension, which contain two key departures from jnc 7. The global hypertension prevalence is estimated to increase from 40% to 50% in the year 2025, with a significant upsurge in future morbidity and mortality due to heart disease and strokes. Stage 1 hypertension at diagnosis consider at or before 6 months of lifestyle modifications if bp goals unmet stage 2 hypertension at diagnosis at diagnosis 1 for frail elderly patients, standing blood pressure measurements should be considered before initiating drug treatment. Revisiting the jnc 7 recommendations jeffery martin, m. A view from a member of jnc 7 benefit either as 1 st or 2 ndline therapy ctd twice as potent as hctz ctd longer duration of action. Jan 21, 2014 the change to a more lenient systolic blood pressure goal may be confusing to many patients who are accustomed to the lower goals of jnc 7, including the hypertension guideline application jnc 7 for palm os and pocketpc 2003.
Jnc 8 hypertension guideline algorithm initial drugs of. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. The jnc 7 executive committee and writing teams were selected entirely from the nhbpep cc because they are recognized as experts in their disciplines by their peers. Carrie armstrong, afp senior associate editor subject. Hypertension course ceufast nursing continuing education. Chicago, il new national guidelines, known as the seventh report of the joint national committee jnc on prevention.
The seventh report of the joint national committee on. Studies show that lowering blood pressure in adults with hypertension by 10 mm hg can reduce the risk of death from cardiovascular disease and stroke by 25% to 40%. The jnc 7 recommendations are fairly universal to good health practicesmaintain a normal body weight, do not smoke, exercise, etc. Smoking cessation control blood glucose and lipids diet eat healthy i. Discover how thousands of men and women worldwide have already used the reverse diabetes today system to lower blood sugar to normal and safely reverse their type 2 diabetes without drugs or insulin. If patient is hypotensive when standing but has mild hypertension. Young women with blood pressures of 12080 mm hg are at very low absolute risk of adverse cardiovascular events.
Jnc 8 guidelines ease up on bp thresholds, drug choices. Chicago, il at long last, the eighth joint national committee jnc 8 has released its new guidelines on the management of adult hypertension, which contain two key departures from jnc 7 that. The previous guidelines jnc 7 was in 2003 and this focused on controlling elevated systolic blood pressure in all adults with hypertension and recommended a bloodpressure goal for all age groups. Individuals with ash stage 2 hypertension jnc 7 stage 1 hypertension frequently have sustained resting bp levels 140. Jnc 7, ada, whoish jnc7 algorithm for treatment of hypertension figure 1 not at goal blood pressuse 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. Pdf on jan 1, 2014, michael r page and others published the jnc 8 hypertension guidelines. Hypertension classification according to jnc 8 summary of jnc 7 and jnc 8 recommendations. High blood pressure remains a leading public health threat. At the heart of the recommendations is the idea that being overly aggressive in bp management may cause more problems with side effects than you gain in stroke and heart attack prevention. Jnc 8 hypertension guideline algorithm lifestyle changes. 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. Hypertension affects 29% us adult population estimated 72 million people, with a prevalence of 65% in persons older than 60 yrs, 1 in 3 adults hypertension disproportionately affects the african american community with over 45% aa males and 46% aa females affected by high blood pressure compared to a national rate of 33%. Explore jnc 8 hypertension guidelines from jama network. Jnc 8 guidelines for the management of hypertension in adults.
For those 65 years old or older, high blood pressure affects women more than men. A view from a member of jnc 7 benefit either as 1 st or 2 ndline therapy ctd twice as potent as hctz ctd longer duration of action hctz 2550 mgd vs. The interactive hypertension guideline tool implements the jnc 7 high blood pressure guidelines for use at the point of care. Prehypertension is 90th percentile 3 separate readings on 3 separate viitisits. 2,3 african americans 47% in women, 43% in men develop high blood. The seventh report of the joint national committee. May 07, 2014 5 thoughts on changes in hypertension treatment. 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 guidelines 1977 jnc 1 1980 jnc 2 1984 jnc 3 1988 jnc 4 1993 jnc 5 1997 jnc 6 2003 jnc 7 delayed waiting for allhat. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc 7 incorporates evidence published since jnc 6 was issued in 1997. The hypertension guidelines jnc 8 linkedin slideshare. In jnc 8, the initial drug choice is broadened to four classes.
What is essentialprimary hypertension htn with no identifiable cause often develops gradually over years. Jnc 7 2014 evidencebased guideline for the management of high blood pressure in adults 2. Department of health and human services national institutes of health national heart, lung, and blood institute. Hypertension remains one of the most important preventable contributors to disease and death. Referral to a hypertension specialist may be indicated for patients in whom goal bp cannot be attained using the above strategy or for the management of complicated needed. It is a primary risk factor for cardiovascular disease and its prevention and management is central to preserving and promoting the cardiovascular health of the nation. The 20 joint european society of hypertension esh and the european society of cardiology esc guidelines recommend that ambulatory bloodpressure monitoring abpm be incorporated into the assessment of cardiovascular risk factors and hypertension. Treatment of hypertension in patients 80 years of age or older. Hypertension is a common disorder that affects approximately 1 billion people and contributes to 1 in 8 deaths. The aim of the update was to provide simplified recommendations for the management of blood pressure based on evidence from randomized controlled trials and the panels expert opinion.
Pdf staying up to date with the jnc 8 hypertension guideline. Jnc 7 simplifies the classification of bloodpressure levels and outlines how to use this new classification scheme for hypertension prevention and. Jnc 8 raises the systolic threshold to 150 mmhg at age 60. I am concerned that the prehypertension classification in the jnc 7 guidelines 1 threatens to medicalize most of the adult population. Perspective on accomplish a typical drug company study novartis selection of an inferior comparator hctz at suboptimal dose used the excuse that it is the most commonly prescribed agent and dose comparison is essentially amlodipine vs hctz amlodipine t12 3850 hrs benazepril t12 812 hrs, trough. Joint national committee 8 jnc 8 guidelines for management. Prehypertension is 90th percentile 3 separate readings on 3 separate visits. Chobanian and his colleagues setand meta goal of completnational high blood pressure. All time human experience hypertension is a major independent risk factor for coronary artery disease, stroke, heart failure, and renal failure 3.
However, individuals with numerous disease markers table iii or limited evidence of early target organ damage such as left ventricular. The jnc 7 hypertension guidelinesthe jnc 7 hypertension. The evidence shows that adults who are younger than 60 years of age should begin medication when the systolic blood pressure reading the top number is 140 mm hg or higher or when. It discusses both the prevalence of hypertension and the relationship between blood pressure and the risk of cardiovascular disease.
Classification of blood pressure the seventh report of. 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. Seventh report of the joint national committee on prevention. 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. Links with this icon indicate that you are leaving the cdc website the centers for disease control and prevention cdc cannot attest to the accuracy of a nonfederal website. Riskbenefit assessment of betablockers and diuretics precludes their use for firstline therapy in hypertension. The etiology of elevated blood pressure is a complex process involving the interaction of genetics, demographics, comorbid disorders, and environmental. What is hypertension jnc 7 what is essentialprimary.