UMEM Educational Pearls

Category: Pharmacology & Therapeutics

Title: JNC 8 Recommendations for Hypertension

Keywords: Hypertension, treatment (PubMed Search)

Posted: 12/21/2013 by Michael Bond, MD (Updated: 5/29/2024)
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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

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.