Reference card from the seventh report of the joint national. Betablockers are no longer considered as firstline drugs, according to jnc 8 guidelines for hypertension. In persons with high normal blood pressure deemed to be at high risk target organ damageclinical. This action was not because the nih was unhappy with their work, but rather because the nih had simply decided that it no longer wanted to sponsor any clinical recommendations of any sort. In the jnc 8 panel guideline, the goal bp changes from jnc 7 also acknowledged that most patients with hypertension would require more than 1 bplowering drug. National institutes of health national heart, lung, and blood institute national high blood pressure education program nih publication no. Whats changed jnc uses randomized trials, and is explicit when a recommendation reflects only expert opinion. Jnc 8 bp target of 80 yrs hypertension in the very elderly trial. Clinical practice guidelines for the management of hypertension in the community. The latest joint national committee guidelines jnc 8 are based on 27 large clinical trials concerning hypertension management. Jnc 8 uses 14090 for patients with diabetes or chronic kidney disease. The 2017 clinical practice guideline for high blood. In jnc 8, the initial drug choice is broadened to four classes. The eighth joint national committee guidelines jnc 8 published in 2014 provides evidence based.
Reduced role for betablockers as initial therapy still pre eminent for hfref and cad, particularly atenolol. Hypothetical jnc 8 recommendations goal bp likely to be refined relaxed for population subgroups, particularly for those 80 and those with dm. Eighth joint national committee jnc 8 guidelines and the outpatient management of hypertension in the africanamerican population nicole abel, krysta contino, navjot jain, navjot grewal, elizabeth grand, iris hagans, krystal hunter, satyajeet roy. The sprint trial systolic blood pressure intervention trial n engl j med 373. About 75 million 32% us adults have high blood pressure. Recently published hypertension guidelines of the jnc 8. Jan 31, 2014 eighth joint national committee jnc 8. Problem magnitude 35 million office visits are as the primary diagnosis of htn. The clinical core of the jnc 8 hypertension guidelines. 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.
Patients will be asking about the new joint national committee jnc 8 hypertension guidelines, which were published in the journal of the american medical association on december 18. Jnc 8 guidelines for the management of hypertension in adults. National institutes of health national heart, lung, and blood institute. Smoking cessation control blood glucose and lipids diet eat healthy i. Jnc 8 guidelines for the management of hypertension in adults author. 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. Chlorthalidone recommended over hctz, but preeminence as first line therapy might be challenged. Jnc 8 report on prevention, evaluation, and treatment of. Jnc8 guidelines for the management of hypertension in adults. Reference card from the seventh report of the joint. Pdf 2014 evidencebased guideline for the management of. Hypertension can lead to many complications, including. See the synopsis section for a summary of the updated hypertension treatment recommendations from the eighth joint national committee jnc 8. New guidelines address the definition, diagnosis, and treatment of hypertension in children and yes, there is a new category.
These trials are often discussed in isolation, but their data have. In 2008, the nhlbi appointed panel members to the eighth joint national committee jnc 8 to update 3 treatmentrelated questions in an evidencebased guideline. The report expenditures and results tool allows users to search a repository of nih funded research projects. Classification of hypertension in jnc 6 was slightly different from that in jnc 5. 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. Recently introduced clinical guidelines for the treatment of hypertension proposed by the eighth joint national committee jnc8 in 2014 recommended a higher systolic blood pressure bp cutoff to initiate antihypertensive treatment than the 2003 jnc7 recommendations 1,2. Consolidates all information about nih supported extramural organizations in a single tool. Carrie armstrong, afp senior associate editor subject. The eighth joint national committee jnc 8 the new guideline has simpli.
Inoffice ambulatory bp monitoring patient selfcheck the national high blood pressure education program is coordinated by the national heart, lung, and blood institute nhlbi at the national institutes of health. Essential hypertension symptoms, diagnosis and treatment. Joint national committee 8 jnc 8 guidelines for management. Impact of treating hypertension moser m, hebert pr. 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. Joint national committee jnc guidelines for hypertension. This evidencebased hypertension guideline focuses on the panels3highest ranked questions related to high bp management. Jama network open original investigation, march 8, 2019. Eighth joint national committee jnc8 guidelines and the. The hypertension experts who had met as the jnc 8 group were similarly cut loose from formal nih sponsorship. Reduced role for betablockers as initial therapy still pre.
Relationship between cognitive functioning and the jnc8. High blood pressure remains a leading public health threat. Jnc 8 recommends thresholds for treatment of high blood pressure, blood pressure goals, and evidencebased medication therapy. Report from the panel members appointed to the eighth joint national committee jnc 8. 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. Secondary hypertension results from other disorders that raise blood pressure in addition to other problems. Blood pressure thresholds and targets 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%. Numerous evidencedbased interventions are available to prevent high blood pressure and improve high blood pressure. 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. 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 diabetes having a target of less than 14090 mm hg. Jnc reports have served as a valuable source of guidelines, and jnc 8 is the most recently updated guideline for the prevention, diagnosis, and treatment of hypertension. Jnc 7 also acknowledged that most patients with hypertension would require more than 1 bplowering drug. Explore jnc 8 hypertension guidelines from jama network. New us guidelines for hypertension in children and.
The panel members appointed to the jnc 8 guideline published a report online in jama last december entitled as 2014 evidencebased guideline for the management of. In 2001, hypertension was attributed to 92 million disabilityadjusted life years throughout the world. Nicole abel, krysta contino, navjot jain, navjot grewal, elizabeth grand, iris hagans, krystal hunter, satyajeet roy. Nine recommendations are made reflecting these questions. 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. Jnc 1 1977 thiazide jnc 2 1980 diuretic jnc 3 1984 thiazide or. John warner, md, president of the american heart association, interviews paul whelton, md, writing group chair for the 2017 hypertension clinical practice guidelines and the need for the guidelines, the new classification system, and.
The new guidelines emphasize control of systolic blood pressure sbp and diastolic blood pressure dbp with age and comorbidityspecific treatment cutoffs. Patients are categorized according to age and the presence of diabetes dm orand chronic kidney disease ckd. Nih research portfolio online reporting tools report. Jnc 8 hypertension guideline algorithm lifestyle changes. Rare, genetic forms of hypertension are caused by mutations in particular genes, many of which help control the balance of fluids and salts in the body and affect blood pressure. With the 2003 joint national committees seventh report jnc 7 becoming increasingly outdated and the 2011 institute of medicine report calling for high. Nih collaborations with other hhs agencies nih intramural research reports the national academies. 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.
In 2014, the eighth joint national committee jnc 8 published the evidencebased guideline for the management of high bp in adults. The eighth joint national committee jnc 8 guideline recommends starting pharmacologic treatment in patients with chronic kidney disease and diabetes if bp. These updated guidelines recommended a target bp of jnc 8 guidelines do not recommend one over the other, but the jackson heart study by harman et al. B jnc 7 2003 thiazide for most without compel indication. In 2008, the nhlbi appointed panel members to the eighth joint national committee jnc 8 to update 3 treatmentrelated questions in.
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. Jnc 8 hypertension guideline algorithm initial drugs of. 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. Guidelines and the outpatient management of hypertension in the africanamerican population. Jnc 8 new guideline hypertension chart pharmacy exam. The causes of essential hypertension, however, are. Prevention of disease progression, left ventricular hypertrophy and congestive heart failure in hypertension treatment trials. Worldwide prevalence estimates for htn may be as much as 1 billion.