Jama network open original investigation, march 8, 2019. 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. Recently published hypertension guidelines of the jnc 8. Recommendations 1 through 5 address questions 1 and 2 concerning thresholds and goals for bp treatment. These trials are often discussed in isolation, but their data have. This applies to all ckd patients with hypertension regardless of race or diabetes status. Updated jnc 8 guidelines for antihypertensive drugs released. Jnc 8 and more hypertension guidelines from the eighth joint national committee jnc 8 are finally here.
Controversy, the jnc8 hypertension guidelines christopher j. The lowest recorded bp at the most recent a office visit with internal medicine, family medicine, endocrinology, cardiology, and nephrology or. Hypertension jnc 7 and jnc 8 and pediatric htn flashcards. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure iii chair aram v. 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. 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%. Start studying hypertension jnc 7 and jnc 8 and pediatric htn.
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. Jnc 8 hypertension guideline algorithm lifestyle changes. The latest joint national committee guidelines jnc 8 are based on 27 large clinical trials concerning hypertension management. Seventh report of the joint national committee on prevention. Prevention of disease progression, left ventricular hypertrophy and congestive heart failure in hypertension treatment trials. While we were waiting for jnc 8, the american society. 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. Reference card from the seventh report of the joint national. 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. While jnc 8 suggests treating patients with both diabetes and hypertension to a blood pressure goal jun 01, 2015 hypertension is a major independent risk factor for coronary artery disease, stroke, heart failure, and renal failure.
Hay, british med j, 1931 hypertension may be an important compensatory mechanism which. Impact of treating hypertension moser m, hebert pr. In addition, jnc 8 draws attention to a subset of the most important prospective clinical trials that provide the evidence base for hypertension management. Understanding these trials and applying their results to individual patients provides more clinical value than guidelines alone can achieve.
In contrast, jnc 8 focuses narrowly on drug treatment. One of every 3 american adultsor approximately 67 million adults 31%has hypertension htn. Smoking cessation control blood glucose and lipids diet eat healthy i. Prehypertension is 90th percentile 3 separate readings on 3 separate viitisits. Patients are categorized according to age and the presence of diabetes dm orand chronic kidney disease ckd. Five jnc 8 members are adding to the cacophony of debate over how best to treat hypertension with a new commentary spelling out their concerns with the final panel recommendations.
Hypertension htn, also known as high blood pressure bp, affects millions of people. Whats good, whats missing, and why are most of the recommendations based on expert opinion. While we were waiting for jnc 8, the american society of hypertension ash in collaboration with the international society of hypertension released their own expert opinion piece aimed at prescribers. In adults with hypertension, does initiating medication therapy at specific bp. 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 management 2017 richard clarens, pharmd. Average sbpdbp 95th percentile for age, gender, and height. 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. Panel members appointed to the eighth joint national committee jnc 8. May 07, 2014 5 thoughts on changes in hypertension treatment.
Jnc 7 2014 evidencebased guideline for the management of high blood pressure in adults 2. Jnc 8 guidelines for the management of hypertension in adults author. Optimal blood pressure management and markers of endorgan damage in africanamerican adult patients were compared between patients who were managed. Learn vocabulary, terms, and more with flashcards, games, and other study tools. What is essentialprimary hypertension htn with no identifiable cause. Those with diabetes mellitus dm and chronic renal insufficiency cri are at higher risk for complications. 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.
Compared with previous hypertension treatment guidelines, the joint national committee jnc 8 guidelines advise. The etiology of elevated blood pressure is a complex process involving the interaction of genetics, demographics, comorbid disorders, and environmental. This guideline addresses blood pressure bp thresholds at which drug therapy should be initiated, bp targets during treatment, and choice of. Pdf on jan 1, 2014, michael r page and others published the jnc 8 hypertension guidelines. Ppt jnc 8 powerpoint presentation free to download id. Hypertension debate continues, as jnc 8 minority speaks. Clinician empathy increases patient trust, motivation, and adherence to therapy.
Hay, british med j, 1931 hypertension may be an important compensatory mechanism which should not be tampered with, even. Jnc 8 guidelines for the management of hypertension in adults. 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. Resources the 7th report of the joint national committee.
If patient is hypotensive when standing but has mild hypertension. This report developed by the panel members appointed to the eighth joint national committee jnc provides clinicians with evidencebased guidelines for blood. The clinical core of the jnc 8 hypertension guidelines. Effects of ace inhibitors, calcium antagonists, and other bloodpressurelowering drugs. 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. 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. Boston university school of medicine, boston, ma executive committee george l. Hypertension guidelines jnc 8 explored by nik nikam md youtube. Carrie armstrong, afp senior associate editor subject. 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. Jnc 8 guidelines were an evidencebased, focused set of rec ommendations. While jnc 8 suggests treating patients with both diabetes and hypertension to a blood pressure goal pdf on oct 17, 2014, rajesh rajan and others published jnc 8 hypertension management guidelines find, read and cite all the research you need on researchgate.
Picmonic is research proven to increase your memory retention and test scores. 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. Pdf on oct 17, 2014, rajesh rajan and others published jnc 8 hypertension management guidelines find, read and cite all the research you need on researchgate. Eshesc, and canadian hypertension education program chep. Joint national committee 8 jnc 8 guidelines for management. In 2014, the eighth joint national committee jnc 8 published the evidencebased guideline. Explore jnc 8 hypertension guidelines from jama network. Eighth joint national committee jnc8 guidelines and the. Hypertension guidelines from the eighth joint national committee jnc 8 are finally here. 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.
Compared with previous hypertension treatment guidelines, the joint national committee jnc 8 guidelines advise higher blood pressure. 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. All time human experience hypertension is a major independent risk factor for coronary artery disease, stroke, heart failure, and renal failure 3. The eighth joint national committee jnc 8 the new guideline has simpli. May 21, 2017 hypertension guidelines jnc 8 explored by nik nikam md please subscribe to this nnn channel by clicking the subscribe button. Jnc 8 bp target of 80 yrs hypertension in the very elderly trial. Hypertension course ceufast nursing continuing education. 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.
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