text-size: + - R

Hot Topic From RxSchool

Hot Topic: New Hypertension Guidelines Published

Darrell Hulisz, RPh, PhamD
Associate Profes

February 3, 2014

The wait is finally over for the Eighth Joint National Committee (JNC-8) guideline on managing hypertension in adults. Compared to the JNC-7 report, the new guidelines are more evidence-based, use more "relaxed" thresholds for treatment, and attempt to simplify antihypertensive care.1 The JNC-8 calls for treatment to lower blood pressure (BP) to 150/90 mm Hg in those age 60 and older, and to 140/90 for adults less than 60. In the population age 18 and older with diabetes, the guidelines recommends initiating drug treatment to a goal of systolic BP<140mmHg, and a diastolic goals of <90mmHg. The same applies to patients with chronic kidney disease (CKD). In the general nonblack population, including those with diabetes, the initial antihypertensive treatment should include either a thiazide, calcium channel blocker (CCB), angiotensin-converting enzyme inhibitor (ACEI), or angiotensin receptor blocker (ARB). In the general black population, including those with diabetes, initial antihypertensive treatment should include a thiazide-type diuretic or CCB. In adults with CKD, initial (or add-on) antihypertensive treatment should include an ACEI or ARB to improve kidney outcomes. This applies to all CKD patients with hypertension regardless of race or diabetes status. As with all consensus guidelines, providing evidence-based recommendations to providers is a useful starting point. However, patients need to be monitored for clinical response, drug regimens should be individualized and dosages titrated. Pharmacists should work to enhance antihypertensive adherence.

1. James PA, Oparil S, Carter BL, et al. 2014 Evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; DOI:10.1001/jama.2013.284427. Available at: http://jama.jamanetwork.com/article.aspx?articleid=1791497

News Topics

Top News Articles