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. Resources the 7th report of the joint national committee. In 2001, hypertension was attributed to 92 million disabilityadjusted life years throughout the world. Average sbpdbp 95th percentile for age, gender, and height. 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. According to the jnc, the decision to treat with medications depends on the overall risk and the degree of hypertension. Historical controversy in treatment of hypertension the greatest danger to a man with high blood pressure lies in its discovery, because then some fool is certain to try to reduce it. In addition, jnc 8 draws attention to a subset of the most important prospective clinical trials that provide the evidence base for hypertension management. Explore jnc 8 hypertension guidelines from jama network. Postgraduate healthcare education, llc does not view the existence of relationships as an implication of bias or that the value of the material is decreased. Dec 24, 20 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.
The etiology of elevated blood pressure is a complex process involving the interaction of genetics, demographics, comorbid disorders, and environmental. Hypertension affects millions of adults in the united states and is a major risk factor for the development of various cardiac, neurological, and renal conditions. Estimated time to complete this activity is 120 minutes. While jnc 8 suggests treating patients with both diabetes and hypertension to a blood pressure goal 8 24 18 23 0 5 10 15 20 25 30 3 6 12. Problem magnitude 35 million office visits are as the primary diagnosis of htn. Recommendation 8 population aged 18 years or older with ckd and hypertension initial or addon antihypertensive treatment should include an acei or arb to improve kidney outcomes.
In adults with hypertension, does initiating medication therapy at specific bp. I have summarized them pretty easily to zip through them. Causes of secondary hypertension with clinical indications and. Prior guidelines set blood pressure goals lower for those with dm or cri, but the newest guidelines from the joint national committee the eighth joint national committee jnc 8 recommend that those with dm andor cri should have a blood pressure goal of 14090 mm hg or lower. 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. If patient is hypotensive when standing but has mild hypertension. While we were waiting for jnc 8, the american society. Jnc 8 guidelines for the management of hypertension in adults. Jnc 8 bp target of 80 yrs hypertension in the very elderly trial. 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. This report developed by the panel members appointed to the eighth joint national committee jnc provides clinicians with evidencebased guidelines for blood. Hypertension remains one of the most important preventable contributors to disease and death. Clinician empathy increases patient trust, motivation, and adherence to therapy. In 2014, the eighth joint national committee jnc 8 published the evidencebased guideline.
The eighth joint national committee jnc 8 the new guideline has simpli. Hypertension is a major independent risk factor for coronary artery disease, stroke, heart failure, and renal failure. Hypertension course ceufast nursing continuing education. Sbp thresholdtarget 150 v 140 50% of ptswith hypertension are. Hypertension guidelines from the eighth joint national committee jnc 8 are finally here. Aug 28, 2014 hypertension htn is a prevalent disease state throughout the united states and is one of the risk factors for developing cardiovascular disease. Those with diabetes mellitus dm and chronic renal insufficiency cri are at higher risk for complications. Hypertension management 2017 richard clarens, pharmd. Evidence was drawn only from randomized controlled trials rcts, which represent the gold. Hypertension htn is a prevalent disease state throughout the united states and is one of the risk factors for developing cardiovascular disease. Hypertension can lead to many complications, including. Jnc 8 guidelines were an evidencebased, focused set of rec ommendations. Resistant hypertension is defined by the seventh joint national committee jnc 7 as the inability to achieve a blood pressure lower than 14090 mm hg despite optimal doses of 3 or more antihypertensive drugs, including 1 diuretic.
Effects of ace inhibitors, calcium antagonists, and other bloodpressurelowering drugs. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure iii chair aram v. Jnc 8 guidelines for the management of hypertension in adults author. While jnc 8 suggests treating patients with both diabetes and hypertension to a blood pressure goal 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. 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. Compared with previous hypertension treatment guidelines, the joint national committee jnc 8 guidelines advise higher blood pressure. 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%. Compared with previous hypertension treatment guidelines, the joint national committee jnc 8 guidelines advise.
Report from the panel members appointed to the eighth joint national committee jnc 8. Recently published hypertension guidelines of the jnc 8. Clinical practice guidelines for the management of hypertension in the community. In the population aged 18 years or older with ckd and hypertension, initial or addon antihypertensive treatment should include an acei or arb to improve kidney outcomes. Jan 31, 2014 recommendation 8 population aged 18 years or older with ckd and hypertension initial or addon antihypertensive treatment should include an acei or arb to improve kidney outcomes. Jun 01, 2015 hypertension is a major independent risk factor for coronary artery disease, stroke, heart failure, and renal failure. Staying up to date with the jnc 8 hypertension guideline article pdf available in jaapa. This applies to all ckd patients with hypertension regardless of race or diabetes status. Prevention of disease progression, left ventricular hypertrophy and congestive heart failure in hypertension treatment trials. Our new crystalgraphics chart and diagram slides for powerpoint is a collection of over impressively designed datadriven chart and editable diagram s guaranteed to impress any audience.
Reference card from the seventh report of the joint national. Provide patients the systolicdiastolic bp readings both verbally and in writing. Whats good, whats missing, and why are most of the recommendations based on expert opinion. Pdf staying up to date with the jnc 8 hypertension guideline. Worldwide prevalence estimates for htn may be as much as 1 billion. 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. Strengths and limitations of the jnc 8 hypertension guidelines. Hypertension highlights 2017 health metrics american heart. One of every 3 american adultsor approximately 67 million adults 31%has hypertension htn. Updated jnc 8 guidelines for antihypertensive drugs released. Pdf on jan 1, 2014, michael r page and others published the jnc 8 hypertension guidelines. May 07, 2014 5 thoughts on changes in hypertension treatment. 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.
To accomplish this, the society established the writing group of the american society of hypertension wgash, chaired by dr. Blood pressure bp thresholds and recommendations for treatment and followup. Carrie armstrong, afp senior associate editor subject. What is essentialprimary hypertension htn with no identifiable cause often develops gradually over years. Understanding these trials and applying their results to individual patients provides more clinical value than guidelines alone can achieve.
Impact of treating hypertension moser m, hebert pr. The new jnc 8 guidelines, which were published in december of 20, displace the prior report of jnc 7. 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. Boston university school of medicine, boston, ma executive committee george l. The lowest recorded bp at the most recent a office visit with internal medicine, family medicine, endocrinology, cardiology, and nephrology or. 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. Hypertension one of the most preventable contributors to disease and death decreases in blood pressure reduce adverse health outcomes blood pressure level mmhg category systolic diastolic normal hypertension in adults.
This applies to all ckd patients with hypertension regardless of. Now, just 2 years after publication of jnc7, the american society of hypertension ash has realized a need to revise their definition of hypertension and recommendations for its recognition and treatment. 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. If you are older than 60 years, the new guideline is to treat for a blood pressure of less. Jama network open original investigation, march 8, 2019. Panel members appointed to the eighth joint national committee jnc 8. Eshesc, and canadian hypertension education program chep. Chart and diagram slides for powerpoint beautifully designed chart and diagram s for powerpoint with visually stunning graphics and animation effects. Reference card from the seventh report of the joint. Hay, british med j, 1931 hypertension may be an important compensatory mechanism which should not be tampered with, even. In contrast, jnc 8 focuses narrowly on drug treatment. The eighth joint national committee jnc 8 guidelines on hypertension have generated great interest among physicians. Patients are categorized according to age and the presence of diabetes dm orand chronic kidney disease ckd. Ppt jnc 8 powerpoint presentation free to download.
Hypertension is a common medical disease, occurring in about one third of young adults, almost two thirds of individuals over the age of 60, and in approximately 75% of individuals older than 70 years. Joint national committee 8 jnc 8 guidelines for management. Prehypertension is 90th percentile 3 separate readings on 3 separate viitisits. If goal bp cannot be reached, consider adding other classes of drugs or referral to a hypertension specialist. Recommendations 1 through 5 address questions 1 and 2 concerning thresholds and goals for bp treatment. Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and. Abundant evidence from randomized controlled trials rcts has shown benefit of antihypertensive drug treatment in reducing important health outcomes in persons with hypertension. Eighth joint national committee jnc8 guidelines and the.