Yes, they are easier to follow, less pressure to reach the target guidelines, very likely better compliance, lesser number of pills, lower cost, but what about long term outcomes?
New Hypertension Guidelines Emphasize Less Stringent Thresholds — Physician’s First Watch
New Hypertension Guidelines Emphasize Less Stringent Thresholds
By Kelly Young
New hypertension guidelines from panel members of the Eighth Joint National Committee (JNC 8) recommend looser blood pressure treatment thresholds for older adults. The guidelines, published in JAMA, update JNC 7 recommendations from over a decade ago.
Drawing from randomized controlled trials, the group recommends that adults aged 60 and older should receive antihypertensive medications if their systolic BP is 150 mm Hg or higher or their diastolic BP is 90 or higher. This is a departure from previous recommendations.
Younger adults should begin drug treatment if their systolic BP is 140 or higher or their diastolic BP is 90 or higher. The 140/90 threshold applies to adults with chronic kidney disease or diabetes as well, also a change.
In nonblack patients, initial drug treatment should include a thiazide-type diuretic, calcium channel blocker (CCB), angiotensin-converting enzyme (ACE) inhibitor, or angiotensin-receptor blocker (ARB). For black patients, treatment should start with a thiazide-type diuretic or CCB. In adults with CKD, therapy should include an ACE-inhibitor or ARB.
Lifestyle interventions are still recommended for all patients. The guideline features an algorithm to guide physicians through treatment options.
Editorialists note that despite previous recommendations to target systolic BP below 140 mm Hg, only about half of Americans with hypertension are below this level. They hint that raising the threshold to 150 in older adults could potentially have significant public health consequences.
Reader Comments (13)
very good and it is helpfull
Excited about JNC 8...
new JNC 8 guidelines make me more comfortable as its become less aggressive than before ( even than last European one ) but i have some concerns regarding the role of ambulatory BP ( where is it from guidlines) and what about the prehypertension as a term , dose it still working or not.
I have followed these apparent NEW guidelines. The past guidelines were difficult to meet,and the patients were reluctant to change their current meds because they were controlled well with them. Of course if they had other NEW issues they were willing to make appropriate med changes.
New Guidelines Equal Better Health
Hi this is great help.
one size does not suit all is well known.BP control has to be individualized and those with early TOD indicating long standing hypertension should have their pressure brought to target in staged manner over longer periods of time.
why we cant strat frm beta blocker ? as this is nt agud choice
i also like to know about new protocols
Good but what about white coat syndrome