Pdf the seventh report of the joint national committee on. Aspcnmapcna guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. By designating fewer categories, jnc 7 simplifies the classification of bp for adults. The etiology of elevated blood pressure is a complex process involving the interaction of genetics, demographics, comorbid disorders, and environmental influences. A specific cause of hypertension, also known as secondary hypertension, can be determined in 10% to 15% of all diagnosed cases. Secondary forms of hypertension are rare and the origin could be. Comparison of hypertension guidelines 20112014 treat if bp. In addition to preventing or reducing high blood pressure, these modi. 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. Eshesc guidelines for the management of arterial hypertension.
Each one was developed after continuous study and randomized control trials. The task force for the management of arterial hypertension of the european. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. However, the american college of cardiology and aha accaha 2017 blood pressure guidelines lowered the threshold for the diagnosis of hypertension to an sbpdbp of 80 mm hg, which led to a new hypertension prevalence of 46% of u. What is essentialprimary hypertension htn with no identifiable cause often develops gradually over years. The treatment of arterial hypertension should start before significant cardiovascular damage develops and is usually lifelong. Hypertension guidelines 1977 jnc 1 1980 jnc 2 1984 jnc 3 1988 jnc 4 1993 jnc 5 1997 jnc 6 2003 jnc 7 delayed waiting for allhat. Pdf the seventh report of the joint national committee on prevention. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure iii chair aram v. The seventh report of the joint national committee on. In the case of an active competitive athlete, it is recommended that once the blood pressure is well controlled, regular followup should be continued with by. Methods the decision to appoint a committee for the seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc 7 was based on 4 factors. Seventh report of the joint national committee on prevention. Hypertension with certain specific additional signs and symptoms may suggest secondary hypertension, i.
Background the recently published sixth report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc vi includes a classification of blood pressure stages and a new risk stratification component. Hypertension course ceufast nursing continuing education. Excessive fluid may contribute to resistant hypertension. Hypertension htn or ht, also known as high blood pressure hbp, is a longterm medical condition in which the blood pressure in the arteries is persistently elevated. The canadian hypertension education program chep was established in 1999 by a group of national societies headed by the canadian hypertension society, the heart and stroke foundation of canada, the canadian coalition for high blood pressure prevention and control, and health canada to maintain annually updated recommendations for. Some new and important features characterize the jnc 7 document. Hypertension is an easily diagnosed and potentially easily treated problem. Hypertension update, jnc8 and beyond sciencedirect. A new classification of blood pressure in adults is suggested, with normal blood pressure bp as. Hypertension htn, also known as high blood pressure bp, affects millions of people. Society of cardiology guidelines for the management of arterial hypertension. The jnc 7 hypertension guidelinesthe jnc 7 hypertension.
Jnc 8 and more hypertension guidelines from the eighth joint national committee jnc 8 are finally here. Hypertension affects 29% us adult population estimated 72 million people, with a prevalence of 65% in persons older than 60 yrs, 1 in 3 adults hypertension disproportionately affects the african american community with over 45% aa males and 46% aa females affected by high blood pressure compared to a national rate of 33%. Patients with highnormal blood pressure or hypertension are stratified into risk group a no associated cardiovascular. I am concerned that the prehypertension classification in the jnc 7 guidelines 1 threatens to medicalize most of the adult population. Results in patients with diastolic blood pressures averaging 115.
Jnc8 guidelines for the management of hypertension in adults. On the other hand, accaha reduced these cutoff values on andor 80 mmhg. Jnc 8 guidelines for the management of hypertension in adults. Pseudo hypertension, a contributing factor to resistant hypertension, may occur in older patients with thick calcified arteries which lead to falsely elevated blood pressure. The criteria for a diagnosis of hypertension are the same in jnc7 and jnc 8. Comparison of the jnc7 and 2017 american college of. Although these guidelines provide evidencebased recommendations for the management of hypertension. Chlorthalidone recommended over hctz, but preeminence as first line therapy might be challenged. 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.
However, if classified as prehypertensive, they would place demands on the medical system that could divert resources from. Alpha blockers lower blood pressure by inhibiting the alpha receptors of arterial smooth muscle. New accaha hypertension guidelines make the new 140. In 2010, hypertension was the leading cause of death and disabilityadjusted lifeyears worldwide, and a greater contributor to events in women and african. Treatment of secondary forms of hypertension differs widely. The seventh report of the joint national committee. 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. Individuals with ash stage 2 hypertension jnc 7 stage 1 hypertension frequently have sustained resting bp levels 140. Citizens for public action on high blood pressure and cholesterol, inc. The main difference between these two recommendations is the definition of arterial hypertension.
Task force for the management of arterial hypertension of the european society of cardiology. Guidelinerecommended antihypertensive medication mostly remained the same in. Blood pressure jnc7 provides additional scien tific evidence to. The etiology of elevated blood pressure is a complex process involving the interaction of genetics, demographics, comorbid disorders, and environmental. Smoking cessation control blood glucose and lipids diet eat healthy i. Jnc 7 used cut off of 140 andor 90 mmhg for systolic and diastolic bp, respectively. The jnc7 guidelines demonstrated a linear association between bp levels and. May 30, 2003 using jnc 7 as a point of departure, an editorialist argues that hypertension control will improve only with substantial changes in the delivery of chronicdisease care and in how the public views lifestyle changes. Reduced role for betablockers as initial therapy still pre eminent for hfref and cad, particularly atenolol. Crossclassification of jnc vi blood pressure stages and. Hypertension is defined as consistently having a systolic blood pressure of 140 mm hg or a diastolic blood pressure of 90 mm hg. 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.
Joint national committee 8 jnc 8 guidelines for management. This often requires intra arterial pressure to assess the actual blood pressure. Average sbpdbp 95th percentile for age, gender, and height. Does the change of hypertension guidelines actually affect. Hypertension the new guidelines the greatest danger to a man with high blood pressure lies in its discovery, because some fool is certain to try and reduce it j. Agents of this class include doxazosin, prazosin, and terazosin. Chobanian and his colleagues setand meta goal of completnational high blood pressure. For example, cushings syndrome frequently causes truncal obesity, glucose intolerance, moon face, a hump of fat behind the neckshoulder referred to as a buffalo hump, and purple abdominal. Explore jnc 8 hypertension guidelines from jama network.
Hypertension is the most preventable major risk factor for cardiovascular morbidity and mortality. The eighth joint national committee guidelines jnc 8 published in 2014 provides evidence based recommendations for management of hypertension and. Using jnc 7 as a point of departure, an editorialist argues that hypertension control will improve only with substantial changes in the delivery of chronicdisease care and in how the public views lifestyle changes. Prehypertension is 90th percentile 3 separate readings on 3 separate viitisits. Cuff inflation hypertension extracellular fluid volume expansion dietary sodium excess obstructive sleep apnea secondary hypertension chronic kidney disease rvh note recent coral trial endocrine hypertension pheochromocytoma, primary mineralocorticoid, etc central hypertension. Hypertension and european society of cardiology jnc 8 versus jnc 7 understanding the evidences i research article. Several emphasize superiority of chlorthalidone or indapamide over thiazide diuretics, and loop diuretics reserved for heart failure or chronic. Revisiting the jnc 7 recommendations jeffery martin, m. The guidelines were created after a committee of experts synthesized all available scientific evidence, and they were updated to provide guidance for doctors for the management of hypertension. Jnc 8 hypertension guideline algorithm initial drugs of.
High blood pressure typically does not cause symptoms. Nuevas guias del american college of cardiologyamerican. The aim of the new and challenging definition of prehypertension bp 12098089. Jnc7 2017 accaha oct 01, 2014 rates of hypertension in younger adults 18 to 59 years are similar under jnc 7 and jnc 8 criteria 20. The seventh report of the joint national committee on the.
Thus, jnc7 is still the final word for several elements of hypertension that jnc 8 did not address, particularly regarding screening, evaluation, diagnosis and classification of high blood pressure. However, individuals with numerous disease markers table iii or limited evidence of early target organ damage such as left ventricular. Jnc 8 recommends thresholds for treatment of high blood pressure, blood pressure goals, and evidencebased medication therapy. Task force for the management of arterial hypertension of the european society of hypertension. Hay 1931 hypertension may be an important compensatory mechanism which should not be tampered with, even were it certain that we. The jnc 7 recommendations are fairly universal to good health practicesmaintain a normal body weight, do not smoke, exercise, etc. For an adult 45 years of age without hypertension, the 40year risk for developing hypertension is 93% for african americans, 92% for hispanics, 86% for whites, and 84% for chinese adults.
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