Updated JNC 8 guidelines for antihypertensive drugs released

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1. Unlike the JNC 7 guidelines, JNC 8 guidelines do not focus on the definition of hypertension and pre hypertension. Instead it aims to define thresholds for pharmacological treatment. A strong recommendation is made to initiate pharmacologic treatment to lower blood pressure to less than 150/90 mm Hg in hypertensive patients aged 60 or older and to a diastolic goal of less than 90 mm Hg in hypertensive patients aged 30 to 59. 

2. While JNC 7 recommended thiazide-type diuretics for initial therapy in the general population, JNC 8 makes a moderate recommendation for selection of initial treatment from a broader range of medications. A thiazide-type diuretic, calcium channel blocker, angiotensin-converting enzyme inhibitor, or angiotensin receptor blocker is reported as an acceptable choice for the general non-black population, including those with diabetes.  

3. JNC 8 makes a moderate recommendation to utilize an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker for blood pressure treatment in all chronic kidney disease patients, regardless of race or diabetes status. 

Statement Rundown: 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. This report developed by the panel members appointed to the eighth Joint National Committee (JNC) provides clinicians with evidence-based guidelines for blood pressure management. While the latest version of the JNC guidelines continues to define high blood pressure as 140/90 mm Hg, it aims to redefine the goals and thresholds for pharmacological treatment and the selection of antihypertensive drugs. While this focused approach is more streamlined than previous versions of the JNC guidelines, it is limited in its application to those patients with numerous comorbidities.  

Click to read the 2014 Hypertension Guideline in JAMA

Click to read 1/3 accompanying editorials in JAMA

Click to read 2/3 accompanying editorials in JAMA

Click to read 3/3 accompanying editorials in JAMA

Relevant Reading: The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure

By Priyanka Vedak and Rif Rahman; Reviewed by Andrew Cheung, MD

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