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. New guidelines recommend that healthcare providers choose an initial drug class ace, arb, ccb, or thiazide. Most people between 9 mmhg sbp or 8089 mmhg dbp will not require medication. Explore jnc 8 hypertension guidelines from jama network. Apr 01, 2014 see the synopsis section for a summary of the updated hypertension treatment recommendations from the eighth joint national committee jnc 8. In many ways, jnc 8 guidelines are simpler than those of jnc 7, 2 with more evidencebased recommendations and less reliance on expert opinion. The eighth joint national committee jnc 8 the new guideline has simpli. The classification of blood pressure in adults 18 years and older is. 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.
Pdf on jan 1, 2014, michael r page and others published the jnc 8 hypertension guidelines. I have summarized them pretty easily to zip through them. The previous guidelines jnc 7 was in 2003 and this focused on controlling elevated systolic blood pressure in all adults with. The eighth report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc 8 recommends for patients aged 60 years. 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 publish their recommendations independently. The impact of jncvi guidelines on treatment recommendations.
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the new accaha guidelines that were in development, given that jnc 7 was published in 2003 and many believed it to be outdated. Reduced role for betablockers as initial therapy still pre. At the heart of the recommendations are 3 key questions. Jnc 8 panel members guideline was published in the journal of the american medical association, it was without the support of any sponsoring organization. Download download jnc 8 hypertension guidelines update read online read online jnc 8 hypertension guidelines update jnc 8 summary jnc 8 guidelines 2016 jnc 8 hypertension guidelines 2015 jnc 8 guidelines algorithm jnc 8 hypertensive emergency jnc 9 guidelines pdf jnc 8 classification of hypertension jnc 8 ppt 1 jun 2015 alabama pharmacy. In subsequent years, a series of joint national committee jnc bp guidelines were published to assist the practice community and improve prevention, awareness, treatment, and control of high bp.
Major differences from the previous jnc report are summarized in table 1. Jnc8 guidelines for the management of hypertension in adults. Although the nih ultimately withdrew from the guideline development process at a late stage in the development of jnc 8, the panel decided. Jnc 8 guidelines advise higher blood pressure goals and less use of several types of. Second, the choice of diuretic in this particular study may be important. Explore the latest in hypertension, including the epidemiology, prevention, treatment, and longterm outcomes of high blood pressure. While jnc 8 suggests treating patients with both diabetes and hypertension to a blood pressure goal hypertension. The jnc has eliminated definitions such as stage 1, 2, and 3 hypertension, and focuses on outcomes instead. Jnc 8 guidelines for the management of hypertension in adults. 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. While jnc 8 suggests treating patients with both diabetes and hypertension to a blood pressure goal jnc 8 published in 2014 provides evidence based recommendations for management of hypertension and is an important reference for clinicians. Patients are categorized according to age and the presence of diabetes dm orand chronic kidney disease ckd. Hypothetical jnc 8 recommendations goal bp likely to be refined relaxed for population subgroups, particularly for those 80 and those with dm.
This study analyzed 61 prospective studies of one million americans aged 4089. Jnc 8 also only discussed four drug classes in its treatment recommendations. Recommendations 1 through 5 address questions 1 and 2 concerning thresholds and goals for bp treatment. This cohort study assesses whether longterm variability and rate of change of blood pressure from young adulthood to midlife are associated with cardiovascular disease and allcause mortality by middle age. Pdf eighth joint national committee jnc8 guidelines.
If you are older than 60 years, the new guideline is to treat for a blood pressure of less. Smoking cessation control blood glucose and lipids diet eat healthy i. Patients are categorized ac cording to age and the presence of diabetes dm orand chronic kidney disease ckd. The new guidelines also introduce new recommendations designed to promote safer use of angiotensin converting enzyme ace inhibitors and. Comparison of current recommendations with jnc 7 guidelines topic jnc 7 jnc 8 drug therapy recommended 5 classes to be considered as initial therapy, but recommended thiazidetype diuretics for most patients specified particular antihypertensive medication classes for patients with compelling indications includes table of oral. Whats covered, whats not, and what else to consider. Start studying jnc 8 guidelines and stepwise approach to the treatment of htn. Featured article new hypertension guidelines published jnc 8 darrell hulisz, rph, pharmd associate professor, cwru, school of medicine the wait is finally over for the eighth joint national committee jnc 8 guideline on managing hypertension in adults. May 07, 2014 5 thoughts on changes in hypertension treatment. More than 2 decades have passed since the publication of the jnc 7 guidelines.
Learn vocabulary, terms, and more with flashcards, games, and other study tools. Jnc 8 is very transparent about its guidelinewriting process, which aspired to the institute of medicines report on creation of trustworthy guidelines. Treatments like the jnc 7 panel, the jnc 8 panel recommended thiazidetype diuretics as initial therapy for most patients. Jnc8 hypertension management guidelines and those who were treated with other regimens. They recommend initiating treatment for hypertension in patients with diabetes whose blood pressure is 14090 mmhg with a treatment goal of sbp jan 21, 2014 the jnc 8 hypertension guidelines. Jnc 8 guidelines for the management of hypertension. Chart and diagram slides for powerpoint beautifully designed chart and diagram s for powerpoint with visually stunning graphics and animation effects. Jnc 8 hypertension guideline algorithm lifestyle changes. The eighth joint national committee jnc 8 recently released evidencebased recommendations on treatment thresholds, goals, and medications in the. The eighth joint national committee guidelines jnc 8 published in 2014 provides evidence based recommendations for management of hypertension and is an important reference for clinicians. Income and life expectancy in the us jnc 8 guideline for management of high blood pressure. Jnc 8 and more hypertension guidelines from the eighth joint national committee jnc 8 are finally here. Hypertension guidelines in 2014 jnc 8 vs all the rest author. This was jnc 8 s most important new recommendation.
Reduced role for betablockers as initial therapy still pre eminent for hfref and cad, particularly atenolol. These guidelines were published by the 8th joint national committee on prevention, detection, evaluation, and treatment of high blood pressure, known as jnc 8. Recommendations 6, 7, and 8 address question 3 concerning selection of antihypertensive drugs. Hypertension update, jnc8 and beyond pharmacology and. Carrie armstrong, afp senior associate editor subject. In the report from the panel members appointed to the eighth joint national committee jnc 8, the guideline authors provide evidencebased. Comparison of current recommendations with jnc 7 guidelines 32 jnc 7 vs jnc 8 methodology. 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 jnc8 guidelines.
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. In both the jnc v and jnc vi, there was a recommendation that all such persons 26. In contrast, recommendations in jnc 8 mostly reflect randomized triallevel evidence, with explicit acknowledgement when a recommendation reflects only expert opinion. Pdf eighth joint national committee jnc8 guidelines and the. However, after the release of the new joint national committee on prevention, detection, evaluation and treatment of high blood pressure 8 jnc 8 guidelines, there have been heated debates with. You can always read the course material free in pdf format. We have adapted much of the rest of their recommendations, but as always, our guideline is a mixture of all. Jnc 8 guidelines for the management of hypertension in adults author. Ppt jnc 8 powerpoint presentation free to download.
The 2015 canadian hypertension education program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Will the results of the accomplish trial affect the. You may have heard that there are guidelines for the management of high blood pressure in adults. Dec 24, 20 moreover, recommendations in jnc 7 were informed liberally by extrapolation from observational data and by expert opinion, as well as by data from randomized trials. Eighth joint national committee jnc8 guidelines and the. 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. Worldwide prevalence estimates for htn may be as much as 1 billion. 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. The 2014 guideline offers recommendations for the management of hypertension in. Lowering treatment to prevent heart attack trial allhat 8 and other trials such as the systolic hypertension in the elderly shep study. The data were so compelling that some members of the jnc 8 panel wanted to keep dbp 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.
Jnc 7 guidelines recommended thiazidetype diuretics as first line treatment for patients without compelling indications for another drug class, but jnc 8 suggests there are four reasonable options for initiation of therapy. Ppt jnc 8 powerpoint presentation free to download id. The latest joint national committee guidelines jnc 8 are based on 27 large clinical trials concerning hypertension management. While jnc 8 suggests treating patients with both diabetes and hypertension to a blood pressure goal 14090 mmhg. The jnc 8 guideline itself has been quite controversial.
To the credit of the panel members of the eighth joint national committee jnc 8, their recommendations have been published independently from the national heart, lung, and blood institute nhlbi and are now available for consideration by practitioners who provide care to patients with hypertension. Jnc 8 does state that jnc 7s definition of hypertension as a blood pressure greater than 14090 remains reasonable. They found a twofold difference in death from ischemic heart disease, stroke or other vascular reasons associated with changes in sbp of 20 mm hg or dsb of 10 mm hg. The clinical core of the jnc 8 hypertension guidelines. Problem magnitude 35 million office visits are as the primary diagnosis of htn. What are the acpaafp and jnc 8 guidelines for initiating.
Report from the panel members appointed to the eighth joint national committee jnc 8 article fulltext available. Jnc 8 guidelines and stepwise approach to the treatment of. While treatment targets may differ among various guidelines, it is important to keep evaluation of the individuals health as the central concern. Partly in response to jnc 8, the american college of cardiology acc and american heart association aha are now in the process of developing of.
Jnc 8 hypertension guideline algorithm initial drugs of. Comparison of current recommendations with jnc 7 guidelines. The eighth joint national committee jnc 8 recommendations have been a major guide to patient management in the primary care setting since they were released in 2014. Joint national committee jnc guidelines for hypertension.