Reduce sodium intake to no more than 2,400 mgday physical activity. The seventh report of the joint national committee on the. This increases the risk for developing several dangerous health conditions including heart attack, stroke, chronic heart failure chf, and kidney disease. It is not intended or designed as a substitute for the reasonable exercise of independent clinical judgment by practitioners. 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. Jnc 7 recommends that patients with hypertension and renal disease receive aceis or arbs. Escesh guidelines on arterial hypertension management of. However, if classified as prehypertensive, they would place demands on the medical system that could divert resources from those. Publications home of jama and the specialty journals of. The incidence and prevalence of cardiovascular and renal complications of hypertension are greater than in ot. Reference card from the seventh report of the joint.
Prehypertension is 90th percentile 3 separate readings on 3 separate viitisits. Definitions the kp national hypertension guideline team uses the jnc 7 classification of hypertension, which is based on. Jnc 8 guidelines for the management of hypertension in adults. Hypertension is an easily diagnosed and potentially easily treated problem. In may 2005, just 2 years after the publication of the jnc 7 guidelines, the american society of hypertension proposed a new definition of hypertension. Recent estimates are that 874 million adults worldwide have an sbp of 140 mm hg or higher. The auscultatory method of bp measurement with a properly calibrated and validated. Worldwide prevalence estimates for htn may be as much as 1 billion. Related editorials assessing the trustworthiness of the guideline for management of high blood pressure in adults.
Machado 1 department of medicine section of pulmonary, critical care, sleep and allergy medicine and section of cardiology, institute for personalized respiratory medicine, university of. Prevention, detection, evaluation, and management of high. Algorithm for treatment of hypertension reference card from the seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc 7 evaluation classification of blood pressure bp category sbp mmhg dbp mmhg normal 80 yrs hypertension in the very elderly trial. The society established the writing group of the american society of hypertension wg. In the jnc 7 guidelines, the 7 categories of blood pres. Citizens for public action on high blood pressure and cholesterol, inc. Clinical practice guidelines for the management of hypertension in the community. In addition, roughly half of hypertensive individuals do not have adequate blood pressure control.
Treatment of isolated systolic hypertension in the elderly. Jnc 8 hypertension guideline algorithm initial drugs of. The eighth joint national committee jnc 8 guidelines on hypertension have generated great interest among physicians. 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. Hypertension treatment algorithm 2014 adapted from jnc8 1 and distributed by the clinicians group of the capitol region right care initiative. Doserelated biochemical adverse effects, such as an increase in serum creatinine 35% above baseline or mild hyperkalemia, should not limit the use of these agents. Joint national committee on prevention, detection, evaluation. Treatment of high blood pressure jnc 7 was based on 4 factors.
The previous guidelines jnc 7 was in 2003 and this focused. The jnc 7 executive committee and writing teams were selected entirely from the nhbpep. 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. Systolic hypertension is an expression of increased arterial stiffness, especially of the large arteries.
Problem magnitude 35 million office visits are as the primary diagnosis of htn. The jnc 7 guidelines were a comprehensive expert consen sus of the. National high blood pressure education program prevention, detection, evaluation, and treatment of high blood pressure the seventh report of the joint national committee on jnc 7 express u. 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. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Treatment algorithm appendix past jnc reports jnc 7, jnc 6, jnc 5, jnc 4, jnc 3, jnc 2, jnc 1. Specifically, it calls for hbp to be treated with lifestyle changes and with medication as needed beginning at 80 mmhg rather than the previous commonly accepted threshold of 14090 mmhg. Hypertension is a leading risk factor for mortality and disability. Hypertension is a major independent risk factor for coronary artery disease, stroke, heart failure, and renal failure. Pdf the seventh report of the joint national committee on. Causes of secondary hypertension with clinical indications and. The jnc 7 hypertension guidelinesthe jnc 7 hypertension.
Hypertension classification according to jnc 8 summary of jnc 7 and jnc 8 recommendations. Diagnostic and therapeutic algorithm for pulmonary. One of every 3 american adultsor approximately 67 million adults 31%has hypertension htn. Treatment algorithm adapted from jnc 8 2 do not use ace inhibitors. Published online in the ahas hypertension journal, the new 2017 guideline covers detection, prevention, management and treatment of high blood pressure hbp. What is essentialprimary hypertension htn with no identifiable cause often develops gradually over years. One important function is to issue guidelines and advisories designed to increase awareness, prevention, treatment, and control of hypertension high blood pressure bp. Sbp 120 mm hg and diastolic blood pressure dbp hypertension. Arterial hypertension in the elderly is a major health economy burden. Some new and important features characterize the jnc 7 document. Definitions from lecture 1 hypertension slides 729, 8592. Jnc 8 only answers a few new questions for the primary care physician, mostly focused on hypertension treatment recommendations.
The joint national commission issued updated hypertension guidelines in december 20 based on more rigorous evidence, and less dependence on expert opinion, than jnc 7. Therapy begins with lifestyle modifica tion, and if the bp goal is not achieved. Jnc 7 its more than high blood pressure request pdf. The aim of the new and challenging definition of prehypertension bp 12098089. 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. Definition and stages of hypertension according to jnc 7jnc 8. 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. Regardless of the method used to assess cv risk, clinicians must be. Northshore medical group hypertension guidelines target values depend on age and comorbidities a hypertensive patient is considered to be out of control if the following bp reading is above target. There is consensus across guidelines jnc 7, eshesc, acog, sogc for the need to acutely manage severe hypertension, defined as systolic bp. Average sbpdbp 95th percentile for age, gender, and height. I am concerned that the prehypertension classification in the jnc 7 guidelines 1 threatens to medicalize most of the adult population. Recheck for goal within one month per jnc8 recommendation 9 1 if blood pressure fails to be maintained at goal, reenter the algorithm where appropriate based on the current individual therapeutic plan.
In 2010, hypertension was the leading cause of death and disabilityadjusted lifeyears worldwide, and a greater contributor to events in women and african. Young women with blood pressures of 12080 mm hg are at very low absolute risk of adverse cardiovascular events. Pdf the seventh report of the joint national committee on prevention, detection, evaluation, and treatment of. Diagnostic and therapeutic algorithm for pulmonary arterial hypertension ankit a. The lowest recorded bp at the most recent a office visit with internal medicine, family medicine, endocrinology, cardiology, and nephrology or. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc 7.
Jnc 7 express the seventh report of the joint national committee on prevention detection evaluation and. Definition and stages of hypertension according to jnc 7. Jnc 8 hypertension guideline algorithm lifestyle changes. The global prevalence of hypertension is high, and among nonpregnant adults in the united states, treatment of hypertension is the most common reason for office visits and for the use of chronic prescription medications. From the bhf glasgow cardiovascular research centre, institute of cardiovascular and medical sciences. Smoking cessation control blood glucose and lipids diet. Kdoqi clinical practice guidelines for chronic kidney disease. Since the publication of the sixth report of the joint national committee on the prevention, detection, evaluation, and. Moderatetovigorous activity 34 days a week averaging 40 min per session. Department of health and human services national institutes of health national heart, lung, and blood institute. In subsequent years, a series of joint national committee jnc bp.
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