High blood pressure remains a leading public health threat. The seventh report of the joint national committee on. Jnc 1 1977 thiazide jnc 2 1980 diuretic jnc 3 1984 thiazide or. 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. Eighth joint national committee jnc8 guidelines and the. 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.
In 2001, hypertension was attributed to 92 million disabilityadjusted life years throughout the world. 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. This evidencebased hypertension guideline focuses on the panels3highest ranked questions related to high bp management. 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 eighth joint national committee jnc 8 the new guideline has simpli. Report from the panel members appointed to the eighth joint national committee jnc 8. 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. Although the nih ultimately withdrew from the guideline development process at a late stage in the development of jnc 8, the panel decided. The report expenditures and results tool allows users to search a repository of nih funded research projects. Consolidates all information about nih supported extramural organizations in a single tool.
See the synopsis section for a summary of the updated hypertension treatment recommendations from the eighth joint national committee jnc 8. The eighth joint national committee guidelines jnc 8 published in 2014 provides evidence based. B jnc 7 2003 thiazide for most without compel indication. 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. 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. In persons with high normal blood pressure deemed to be at high risk target organ damageclinical. Jnc 8 hypertension guideline algorithm initial drugs of. National institutes of health national heart, lung, and blood institute. Jnc 8 hypertension guideline algorithm lifestyle changes. 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. Impact of treating hypertension moser m, hebert pr. Prevention of disease progression, left ventricular hypertrophy and congestive heart failure in hypertension treatment trials. In 2014, the eighth joint national committee jnc 8 published the evidencebased guideline for the management of high bp in adults.
Essential hypertension symptoms, diagnosis and treatment. Jnc 8 bp target of 80 yrs hypertension in the very elderly trial. 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%. About 75 million 32% us adults have high blood pressure. Jnc8 guidelines for the management of hypertension in adults. Nine recommendations are made reflecting these questions. Nih research portfolio online reporting tools report. Jnc 8 guidelines for the management of hypertension in adults author. In 2008, the nhlbi appointed panel members to the eighth joint national committee jnc 8 to update 3 treatmentrelated questions in. Chlorthalidone recommended over hctz, but preeminence as first line therapy might be challenged.
Smoking cessation control blood glucose and lipids diet eat healthy i. Hypertension can lead to many complications, including. The 2017 clinical practice guideline for high blood. Joint national committee jnc guidelines for hypertension. 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. With the 2003 joint national committees seventh report jnc 7 becoming increasingly outdated and the 2011 institute of medicine report calling for high. The eighth joint national committee jnc 8 guideline recommends starting pharmacologic treatment in patients with chronic kidney disease and diabetes if bp. 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. Problem magnitude 35 million office visits are as the primary diagnosis of htn. Relationship between cognitive functioning and the jnc8. Specific coverage decisions are based upon plan document language in the geha member brochure. New guidelines address the definition, diagnosis, and treatment of hypertension in children and yes, there is a new category. The new guidelines emphasize control of systolic blood pressure sbp and diastolic blood pressure dbp with age and comorbidityspecific treatment cutoffs.
Classification of hypertension in jnc 6 was slightly different from that in jnc 5. 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. Jnc 7 also acknowledged that most patients with hypertension would require more than 1 bplowering drug. 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.
Jan 31, 2014 eighth joint national committee jnc 8. The sprint trial systolic blood pressure intervention trial n engl j med 373. National institutes of health national heart, lung, and blood institute national high blood pressure education program nih publication no. Reduced role for betablockers as initial therapy still pre eminent for hfref and cad, particularly atenolol. Pdf 2014 evidencebased guideline for the management of. Nih collaborations with other hhs agencies nih intramural research reports the national academies. Nicole abel, krysta contino, navjot jain, navjot grewal, elizabeth grand, iris hagans, krystal hunter, satyajeet roy. Jnc 8 recommends thresholds for treatment of high blood pressure, blood pressure goals, and evidencebased medication therapy. 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. Jnc 8 guidelines for the management of hypertension in adults.
Reference card from the seventh report of the joint national. Recently published hypertension guidelines of the jnc 8. Whats changed jnc uses randomized trials, and is explicit when a recommendation reflects only expert opinion. The causes of essential hypertension, however, are. Reference card from the seventh report of the joint. Betablockers are no longer considered as firstline drugs, according to jnc 8 guidelines for hypertension. New us guidelines for hypertension in children and. Numerous evidencedbased interventions are available to prevent high blood pressure and improve high blood pressure. 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. Explore jnc 8 hypertension guidelines from jama network. Carrie armstrong, afp senior associate editor subject. 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.
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. Secondary hypertension results from other disorders that raise blood pressure in addition to other problems. Guidelines and the outpatient management of hypertension in the africanamerican population. Effects of ace inhibitors, calcium antagonists, and other bloodpressurelowering drugs. The sixth report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure nationalinstitutes ofhealth national heart, lung, and blood institute national high blood pressure education program nih publication no. In 2008, the nhlbi appointed panel members to the eighth joint national committee jnc 8 to update 3 treatmentrelated questions in an evidencebased guideline. Jnc 8 report on prevention, evaluation, and treatment of. Jama network open original investigation, march 8, 2019. The latest joint national committee guidelines jnc 8 are based on 27 large clinical trials concerning hypertension management.
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. These trials are often discussed in isolation, but their data have. Hypothetical jnc 8 recommendations goal bp likely to be refined relaxed for population subgroups, particularly for those 80 and those with dm. Patients are categorized according to age and the presence of diabetes dm orand chronic kidney disease ckd. 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. New us guidelines for hypertension in children and adolescents. Reduced role for betablockers as initial therapy still pre. Jnc 8 uses 14090 for patients with diabetes or chronic kidney disease. Jnc 8 raises the systolic threshold to 150 mmhg at age 60. 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. 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. The hypertension experts who had met as the jnc 8 group were similarly cut loose from formal nih sponsorship. Joint national committee 8 jnc 8 guidelines for management.
In jnc 8, the initial drug choice is broadened to four classes. 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. Eighth joint national committee jnc8 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. 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.
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