The sixth report of the joint national committee on. Jnc 8 hypertension guideline algorithm lifestyle changes. Classification of blood pressure the seventh report of the. Clinical practice guidelines for the management of hypertension in the community. Detection, evaluation, and treatment of high blood pressure jnc 7 evaluation classification of blood pressure bp category sbp mmhg dbp mmhg normal jnc 7 was based on four factors. Jnc 8 raises the systolic threshold to 150 mmhg at age 60. Young women with blood pressures of 12080 mm hg are at very low absolute risk of adverse cardiovascular events. The treatment goal for individuals with hypertension and no other compelling conditions is detection, evaluation, and treatment of high blood pressure. Jnc 7, ada, whoish jnc7 algorithm for treatment of hypertension figure 1 not at goal blood pressuse pdf vi foreword the purpose of the sixth report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc vi is to provide guidance for primary care clinicians. Jnc 7 recommends that patients with hypertension and renal disease receive aceis or arbs. The committee recognizes that the responsible clinicians judgment of the individual patients needs remains paramount. 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. Eduardo hernandezvila, md hypertension is a major independent risk factor for coronary artery disease, stroke, heart failure, and renal failure.
The seventh report of the joint national committee on. It includes modification of jnc 7 regarding the threshold for therapy, therapeutic goals, and medications or combinations of medications that differ in benefits for certain. Reference card from the seventh report of the joint. This guideline updates the seventh report of the joint national committee on prevention, detection, evaluation and treatment of high blood pressure jnc 7. Average sbpdbp 95th percentile for age, gender, and height. As many as 55,000 deaths are directly attributed to hypertension each year, and it is considered an underlying or contributing factor in at least another 300,000. The concepts for the new report identified by the nhbpep.
Referral to a hypertension specialist may be indicated for patients in whom goal bp cannot be attained using the above strategy or for the management of complicated needed. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc 7, 2003 2. Hypertension unspecified icd 10 icd10 code for secondary hypertension, unspecified i15. Jnc 7 becoming increasingly outdated and the 2011 institute of medicine report calling for highquality evidencebased guidelines, 7,8 the eighth joint national committee jnc 8 was initially appointed to create an updated treatment guideline for hypertension under the auspices of the national institutes of health nih. Chobanian and his colleagues setand meta goal of completnational high blood pressure. Nov, 2017 this guideline updates the seventh report of the joint national committee on prevention, detection, evaluation and treatment of high blood pressure jnc 7. Seventh report of the joint national committee on prevention. Pdf the seventh report of the joint national committee on. One important function is to issue guidelines and advisories designed to increase awareness, prevention, treatment, and control of hypertension high blood pressure bp.
Apr 09, 2019 hypertension unspecified icd 10 icd10 code for secondary hypertension, unspecified i15. Jnc 7, ada, whoish jnc7 algorithm for treatment of hypertension figure 1 not at goal blood pressuse jnc 8 published in 2014 provides evidence based recommendations for management of hypertension and is an important reference for clinicians. Recently published hypertension guidelines of the jnc 8. Jnc7 emphasizes the marked prevalence of hbp in the elderly. Americans have high blood pressure bp warranting some form of treatment. Classification of blood pressure the seventh report of. Pdf staying up to date with the jnc 8 hypertension guideline evidence based recommendations on the diagnosis and management of hypertension high blood pressure in. The jnc 7 recommendations are fairly universal to good health practicesmaintain a normal body weight, do not smoke, exercise, etc. An estimated 73 million people in the united states live with hypertension.
Pdf staying up to date with the jnc 8 hypertension guideline evidence based recommendations on the diagnosis and management of hypertension high blood pressure in adults. The jnc 7 hypertension guidelinesreply jama network. Jnc 8 guidelines for the management of hypertension in adults. Cdc will be examining the updated recommendations closely to determine their effect on national cardiovascular disease prevention activities. Jnc 8 uses 14090 for patients with diabetes or chronic kidney disease. Jnc 8 hypertension guideline algorithm initial drugs of. There is consensus across guidelines jnc 7, eshesc, acog, sogc for the need to acutely manage severe hypertension, defined as systolic bp. Whats changed jnc uses randomized trial evidence, and is explicit when a recommendation reflects only expert opinion. Hypertension is the most common primary diagnosis in the united states, with only modest gains in awareness, treatment, and control of bp over the. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. In jnc 8, the initial drug choice is broadened to four classes. Since the publication of the sixth report of the joint national committee on the prevention, detection, evaluation, and. The jnc 7 guidelines were a comprehensive expert consen sus of the prevention, detection, evaluation, and treatment of high blood pressure in adults chobanian 2003, whereas the jnc 8 guidelines were an evidencebased, focused set of recommendations. As per the jnc 7 criteria the seventh report of the joint national committee on prevention, detection, evaluation and treatment of high blood pressure, 2003.
Hypertension is an easily diagnosed and potentially easily treated problem. Effects of ace inhibitors, calcium antagonists, and other bloodpressurelowering drugs. Joint national committee jnc guidelines for hypertension. Impact of treating hypertension moser m, hebert pr. 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. Jnc 8 only answers a few new questions for the primary care physician, mostly focused on hypertension treatment recommendations. The jnc 7 recommenda tions are fairly universal to good health practices main tain a normal body weight, do not smoke, exercise, etc. Prevention of disease progression, left ventricular hypertrophy and congestive heart failure in hypertension treatment trials. What is hypertension jnc 7 what is hypertension for childrenadolescents.
Prehypertension is 90th percentile 3 separate readings on 3 separate visits. Individuals with ash stage 2 hypertension jnc 7 stage 1 hypertension frequently have sustained resting bp levels 140. The society established the writing group of the american society of hypertension wg. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure iii chair aram v.
Prehypertension is 90th percentile 3 separate readings on 3 separate viitisits. The jnc 7 hypertension guidelinesreply jama jama network. Betablockers are no longer considered as firstline drugs, according to jnc 8 guidelines for hypertension. Hypertension update, jnc8 and beyond sciencedirect. What is hypertension jnc 7 what is essentialprimary. Making sense of the us hypertension guideline in 2018. Jnc 7 becoming increasingly outdated and the 2011 institute of medicine report calling for highquality evidencebased guidelines,7,8 the eighth joint national committee jnc 8 was initially appointed to create an updated treatment guideline for hypertension under the auspices of the national institutes of health nih. Jnc 7 suggests that all people with hypertension stages 1 and 2 be treated. Jnc reports have served as a valuable source of guidelines, and jnc 8 is the most recently updated guideline for the prevention, diagnosis, and treatment of hypertension. This classification does not stratify hypertensive individuals by the presence or absence of risk factors or target organ damage in order to make different treatment recommendations, should either or both be present. 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. This increases the risk for developing several dangerous health conditions including heart attack, stroke, chronic heart failure chf, and kidney disease. However, individuals with numerous disease markers table iii or limited evidence of early target organ damage such as left ventricular.
The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc 7 recommends that thiazidetype diuretics should be prescribed as initial therapy for most patients with hypertension. What is essentialprimary hypertension htn with no identifiable cause often develops gradually over years. Smoking cessation control blood glucose and lipids diet eat healthy i. 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. Boston university school of medicine, boston, ma executive committee george l. I am concerned that the prehypertension classification in the jnc 7 guidelines 1 threatens to medicalize most of the adult population. The previous guidelines jnc 7 was in 2003 and this focused on controlling elevated systolic blood pressure in all adults with. Jnc 8 hypertension guidelines acp arizona chapter annual meeting 2014 shakaib rehman, md, sch, facp, faach. Treatment of high blood pressure jnc 7 was based on 4 factors. In addition to preventing or reducing high blood pressure, these modi. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure jnc 7.