Professional Documents
Culture Documents
• None
Objectives
• Released in 2003
JNC 7 Key messages 3
1. Age > 50, SBP >140 is much more important CVD risk factor than
DBP
• Released in 2014
JNC 8 4
New guidelines 5
• 2017
ACC/AHA/AAPA/ABC/ACPM/AGS/AphA/ASH/ASPC/N
MA/PCNA Guidelines for the Prevention, Detection, Evaluation,
and Management of High Blood Pressure in Adults
SBP DBP
Hypertension
≥130/80 or ≥140/90 or
reported BP reported BP
Med Med
Normal BP Elevated BP
(<120/80) (120-129/<80)
No Yes Nonpharmacologic
Nonpharmacologic Clinical ASCVD or 10
Therapy and
Therapy yr CVD risk ≥10%
Medication
Atherosclerotic Cardiovasular
Reassess in 3-6 months Disease Calculator Reassess in 1 month
• Protocol differences
SBP DBP
Hypertension
• Give Meds if ASCVD risk greater than 10 % for stage 1 and all
people in stage 2
Why different from
JNC 8? 5,6
• Published in 2015
• Randomly assigned 9361 people with BP >130 but <180 and
an increased cardiovascular risk to target less than 120 or less
than 140
• Age greater than 50
• Increased CV risk defined as one or more of the following:
• Clinical or subclinical CV disease other than stroke
• CKD with eGFR of 20 to less than 60 ml/min
• 15% or greater Framingham score
• Age 75 or greater
• MI
• Stroke
• Heart Failure
2. Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. JAMA.
1977;237(3): 255-261
3. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood
Pressure The JNC 7 Report. JAMA. 2003; 289(19);2560-2571
4. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults Report from the Panel Members
appointed to the Eight Joint National Committee. JAMA. 2014;311(5);507-520
7. The SPRINT Research Group. A randomized trial of intensive vs standard blood pressure control. NEJM 2015; 373(22);
2103-2116.