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Joint National Committee on High Blood Pressure

2003 recommendations: - any blood pressure (BP) over 115/75 mm Hg increases risk of death from heart disease & stroke - this risk doubles with each 20/10 mm Hg increase in BP 4 categories of blood pressure 1) normal: < 120/80 mm Hg 2) prehypertension: 120-139/80-89 mm Hg 3) stage 1 hypertension: 140-159/90-99 mm Hg 4) stage 2 hypertension: 160/100 mm Hg or higher Management: BP goals: - < 140/90 mmg Hg for most patients - ACP, JNC8 current recommendations: < 140/90 mmg Hg for patients with diabetes mellitus or chronic renal failure [4] - JNC8 recommends treatment of chronic hypertension with antihypertensive in patients >= 60 years of age when blood pressure is > 150/90 mm Hg [4] - JNC8 recommendations still < 140/90 for patients >= 60 with diabetes mellitus or chronic renal disease [4] * JNC7 recommendations: < 130/80 mmg Hg for patients with diabetes mellitus or chronic renal failure [3] initial antihypertensive options include ACE inhibitor, ARB, calcium channel blocker or thiazide diuretic [4] (JNC8) - Thiazide diuretics are recommended as 1st-line therapy of uncomplicated hypertension [3] (JNC7) Combination therapy is often needed to control BP Life-style changes: 1) weight loss 2) exercise 3) limiting alcohol 4) smoking cessation DASH diet recommended. Avoid low-dose aspirin if BP not controlled to reduce risk of hemorrhagic stroke.

Related

blood pressure (BP) hypertension (HTN, high blood pressure, HBP)

References

  1. Prescriber's Letter 10(6):31 2003
  2. Journal Watch 24(1):5, 2004 - Chobanian AV, Bakris GL, Black HR et al The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 289:2560, 2003 PMID: 12748199
  3. Chobanian AV et al Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 42:1206, 2003 PMID: 14656957
  4. Medscape: Dec 18, 2013 JNC 8 at Last! Guidelines Ease Up on BP Thresholds, Drug Choices. http://www.medscape.com/viewarticle/817991 - James PA et al 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults. Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. Published online December 18, 2013 PMID: 24352797 http://jama.jamanetwork.com/article.aspx?articleid=1791497 - Bauchner H et al Updated Guidelines for Management of High Blood Pressure Recommendations, Review, and Responsibility. JAMA. Published online December 18, 2013. PMID: 24352759 http://jama.jamanetwork.com/article.aspx?articleid=1791423 - Peterson ED et al Recommendations for Treating Hypertension. What Are the Right Goals and Purposes? JAMA. Published online December 18, 2013. PMID: 24352710 http://jama.jamanetwork.com/article.aspx?articleid=1791422 - Sox HC Assessing the Trustworthiness of the Guideline for Management of High Blood Pressure in Adults. JAMA. Published online December 18, 2013. PMID: 24352688 http://jama.jamanetwork.com/article.aspx?articleid=1791421