UMEM Educational Pearls

Title: JNC 8 Recommendations for Hypertension

Category: Pharmacology & Therapeutics

Keywords: Hypertension, treatment (PubMed Search)

Posted: 12/21/2013 by Michael Bond, MD (Updated: 12/26/2024)
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JNC8 (the Eigth Joint National Commission) released their recommendations for blood pressure management this week. The full article as published in JAMA can be found at http://jama.jamanetwork.com/article.aspx?articleid=1791497

Highlights from this report are

Older adults do not need to be placed on antihypertensive medications unless their SBP > 150 or DBP > 90.
Younger patients should still be started if their SBP > 140 or DBP > 90.
Firstline drug treatment recommendations are:
- Non-black patients: start with thiazide diuretics, calcium channel blockers, angiotension converting enzyme (ACE) inhibitors, or angiotension-receptor blockers (ARBs).
- For black patients start with thiazide diuretics or calcium channel blockers.
- Patients with chronic kidney disease should be on an ACE or ARB.

General Pearl: Remember to be cautious in acutely lowering the blood pressure in asymptomatic patients. Acute lowerings can cause watershed ischemia leading to strokes.