Breaking News: JNC 8 Guidelines Released

December 19, 2013

By Monica Gupta, MD

On December 18, 2013, the long awaited JNC 8 guidelines were published. Two major deviations from JNC 7 are: 1) more relaxed blood pressure goals and cutoffs for initiation of treatment, and 2) recommendations for first line therapy.

Simplified, JNC 8’s major recommendations are as follows:

  1. In those 60 years or older, blood pressure lowering agents should be initiated to achieve a goal SBP < 150 mmHg and a goal DBP < 90 mmHg.
  2. In those 60 years or younger, blood pressure lowering agents should be initiated for a goal SBP < 140 mmHg and a goal DBP < 90 mmHg. These same recommendations can be applied to those 18 years or older with chronic kidney disease and to those 18 years or older with diabetes.
  3. In the general non-black population, including those with diabetes, first line anti-hypertensives can include a thiazide diuretic, CCB, ACEi or ARB. In the general black population, initial anti-hypertensive treatment should include a thiazide diuretic or CCB.
  4. In those 18 years and older with CKD, initial therapy should include an ACEi or ARB to improve kidney outcomes.

The full recommendations can be found here:

http://jama.jamanetwork.com/article.aspx?articleid=1791497

Dr. Monica Gupta is a 2nd year internal medicine resident at NYU Langone Medical Center

Image courtesy of Wikimedia Commons

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