Treatment of high blood pressure jnc 7 was based on 4 factors. The jnc8 guidelines differ from the jnc 7 guidelines in two key areas. The jnc 7 report 1 recommended a blood pressure goal of 85 mm hg for patients with diabetes. Betablockers are no longer considered as firstline drugs, according to jnc 8 guidelines for hypertension. These new insights were incorporated into the jnc 7 guidelines figure 3.
Jnc 8 hypertension guideline algorithm initial drugs of. It includes modification of jnc 7 regarding the threshold for therapy, therapeutic goals, and medications or combinations of medications that differ in benefits for certain. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure iii chair aram v. Revisiting the jnc 7 recommendations jeffery martin, m. I am concerned that the prehypertension classification in the jnc 7 guidelines 1 threatens to medicalize most of the adult population. Smoking cessation control blood glucose and lipids diet eat healthy i. Inconclusive evidence to lower sodium 7% o glucosa postcarga198 mgdl enfermedadcv establecida o enfermedad. Pdf the seventh report of the joint national committee on prevention.
Staying up to date with the jnc 8 hypertension guideline jaapa journal of the american academy of physician assistants. For strategies a and b, add and titrate thiazidetype diuretic or acei or arb or ccb use medication class not previously selected. Hypertension treatment algorithm adapted from jnc8 and distributed by the clinicians group of the capitol region right care initiative at goal blood pressure. Joint national committee vii and european society of hypertension. Jnc 8 hypertension guidelines acp arizona chapter annual meeting 2014 shakaib rehman, md, sch, facp, faach associate chief of staff for education phoenix va healthcare systems professor of medicine professor of biomedical informatics university of arizona college of medicinephoenix. 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 8 guidelines for the management of hypertension in adults. Causes of secondary hypertension with clinical indications and. Jaap 49 with uncontrolled hypertension, nearly 90% have a usual. Installation instructions and download of hypertension guideline application jnc 7 for palm os and pocketpc 2003. Joint national committee jnc guidelines for hypertension.
The jnc 7 executive committee and writing teams were selected entirely from the nhbpep cc. By designating fewer categories, jnc 7 simplifies the classification of bp for adults. Reference card from the seventh report of the joint. Kdoqi clinical practice guidelines for chronic kidney disease. Openclinical clinical applications jnc 7 hypertension. The interactive hypertension guideline tool implements the jnc 7 high blood pressure guidelines for use at the point of care. The seventh report of the joint national committee on prevention, detection, evaluation, and the treatment of high blood pressure the nhlbi jnc 7 press conference. In the absence of such evidence, the panel recommends an sbp goal of lower than mm hg and a dbp goal lower than 90 mm hg in this population based on expert opinion, consistent with the bp goals in recommendation 3 for the general population younger than 60 years with hypertension. Jnc 8 bp target of 80 yrs hypertension in the very elderly trial.
High blood pressure is a common condition, afflicting 29% of the adult. Table 1 lists the classification and management strategy for bp in adults in the jnc 7 guidelines. Citizens for public action on high blood pressure and cholesterol, inc. Hypertension management controversies in the elderly patient. This study analyzed 61 prospective studies of one million americans aged 4089. Blood pressure jnc7 provides additional scien tific evidence to. Chobanian and his colleagues setand meta goal of completnational high blood pressure. The aim of the new and challenging definition of prehypertension bp 12098089.
Worldwide prevalence estimates for htn may be as much as 1 billion. Some new and important features characterize the jnc 7 document. The jnc 7 hypertension guidelinesthe jnc 7 hypertension. Jnc 6, 1997 34 pages jnc 7, 2003 47 pages appointed by nhlbinih national high blood pressure education program. Both of these documents have raised interest among experts and clinicians, and a. The jnc 7 executive committee and writing teams were selected entirely from the nhbpep cc because they are recognized as experts in their disciplines by their peers. The aim of the update was to provide simplified recommendations for the management of blood pressure based on evidence from randomized controlled trials and the panels expert opinion. Jnc 6 and other nhbpep clinical guidelines was selected. Jnc 8 only answers a few new questions for the primary care physician, mostly focused on hypertension treatment recommendations. National high blood pressure education program prevention, detection, evaluation, and treatment of high blood pressure the seventh report of the joint national committee on jnc 7 express u.
Newer therapies in management of hypertension 1142014 george thomas, md. According to many patients and doctors in the early 1970s, this was considered normal. Although the nih ultimately withdrew from the guideline development process at a late stage in the development of jnc 8, the panel decided. The seventh report of the joint national committee on the. In an accompanying editorial, dr thomas e kottke cardiovision 2020, olmstead county, mn and colleagues write that while the new jnc 7 report documents ways that the burden of hypertension can. The previous guidelines jnc 7 was in 2003 and this focused on controlling elevated systolic blood pressure in all adults with.
Problem magnitude 35 million office visits are as the primary diagnosis of htn. Individuals with ash stage 2 hypertension jnc 7 stage 1 hypertension frequently have sustained resting bp levels 140. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Young women with blood pressures of 12080 mm hg are at very low absolute risk of adverse cardiovascular events. 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. Society of cardiology guidelines for the management of arterial hypertension. Meets criteria for htnmeets criteria for htn results from an identifiable, potentially correctable cause accounts for significant number of resistant htn cases estimated to account for 515% of cases of htn prevalence of hypertension in adults between 2030% 5070 million people. For example, both the jnc vii and the eshesc guidelines 1,2 recognize the benefits of. This increases the risk for developing several dangerous health conditions including heart attack, stroke, chronic heart failure chf, and kidney disease. Jnc 8 hypertension guideline algorithm lifestyle changes. Algorithm for treatment of hypertension reference card from the seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc 7 evaluation classification of blood pressure bp category sbp mmhg dbp mmhg normal high blood pressure jnc 7, this level of bp will now be termed prehypertensive and is an indication for lifestyle modifications. Such individuals are at increased risk for the development of hypertension and, therefore, should be encouraged to undergo lifestyle modification as well as frequent monitoring. Jnc 7 sets a novel approach to the management of hypertension with emphasis on patients classified as prehypertensives.
Use of jnc 7 high blood pressure tool is restricted to health professionals. The jnc 7 hypertension guidelinesreply jama jama network. In the 2003 guidelines, classification of hypertension was similar to that in jnc 7, and indications for ambulatory blood pressure monitoring and measurement of home blood pressure were suggested. The treatment of arterial hypertension should start before significant cardiovascular damage develops and is usually lifelong.
Detection, evaluation and treatment of high blood pressure jnc 7 and is a comprehensive resource for the clinical and public health practice communities. Compared to 2003 guidelines, classification of hypertension changed only slightly in 2007, with no subsequent change in 20. Finally, two or more drugs are typically needed to reduce elevated bp to target ranges. Pdf the seventh report of the joint national committee on.
Pdf staying up to date with the jnc 8 hypertension guideline. According to jnc7 guidelines, which is more important as a risk factor for cvd sbp or dbp. None of the larger controlled studies 2 5 of hypertension in patients with diabetes mellitus, however, achieved a mean systolic blood pressure of less than 140 mm hg, despite intensive treatment. In subsequent years, a series of joint national committee jnc bp.
Department of health and human services national institutes of health national heart, lung, and blood institute. Yes no reinforce medication and lifestyle adherence. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc 7. Boston university school of medicine, boston, ma executive committee george l. Evaluation, and treatment of high blood pressure jnc. The new hypertension guidelines from jnc 7 mayo clinic. The joint national commission issued updated hypertension guidelines in december 20 based on more rigorous evidence, and less dependence on expert opinion, than jnc 7. The seventh report of the joint national committee on. A new classification of blood pressure in adults is suggested, with normal blood pressure bp as.
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