hypertension is a comorbidity which we commonly come across in our daily practice. As an entity which can be easily optimized, updates about new guidelines with respect to classification and treatment are paramount for effective management..
the eight report of the joint national committee for treatment of hypertension is due for release early next year.
an excerpt of the 8th report is attached herewith:
with the eighth report due in fall 2011,NHLBI is embarking on a new guideline effort aimed at developing an evidence-based, comprehensive, integrated set of clinical guidelines for cardiovascular risk reduction directed principally at primary care practitioners to help adult patients reduce their risk for CVD. This includes both a long-term strategy of developing integrated guidelines and a shorter-term strategy of producing focused updates of the existing guidelines for high blood pressure, cholesterol, and obesity as elements of the overall integrated guideline process.
3 separate sub panels to address high blood pressue /dyslipidemia (ATP3),hypertension (JNC7) and overweight/obesity(obesity guidelines) shall be convened. A cardiovascular knowledge network (CKN) shall also be instituted.
for more information about JNC 8
abstract of JNC 7
The “Seventh Report of the Joint National Committee on Prevention,
Detection, Evaluation, and Treatment of High Blood Pressure” provides a
new guideline for hypertension prevention and management. The following
are the report’s key messages:
• In persons older than 50 years, systolic blood pressure greater than
140 mmHg is a much more important cardiovascular disease (CVD) risk
factor than diastolic blood pressure.
• The risk of CVD beginning at 115/75 mmHg doubles with each
increment of 20/10 mmHg; individuals who are normotensive at age
55 have a 90 percent lifetime risk for developing hypertension.
• Individuals with a systolic blood pressure of 120–139 mmHg or a
diastolic blood pressure of 80–89 mmHg should be considered as
prehypertensive and require health-promoting lifestyle modifications
to prevent CVD.
• Thiazide-type diuretics should be used in drug treatment for most
patients with uncomplicated hypertension, either alone or combined with
drugs from other classes. Certain high-risk conditions are compelling
indications for the initial use of other antihypertensive drug classes
(angiotensin converting enzyme inhibitors, angiotensin receptor blockers,
beta-blockers, calcium channel blockers).
• Most patients with hypertension will require two or more antihypertensive
medications to achieve goal blood pressure (<140/90 mmHg, or
<130/80 mmHg for patients with diabetes or chronic kidney disease).
• If blood pressure is >20/10 mmHg above goal blood pressure, consideration
should be given to initiating therapy with two agents, one of which usually
should be a thiazide-type diuretic.
• The most effective therapy prescribed by the most careful clinician will
control hypertension only if patients are motivated. Motivation improves
when patients have positive experiences with, and trust in, the clinician.
Empathy builds trust and is a potent motivator.
• In presenting these guidelines, the committee recognizes that the responsible
physician’s judgment remains paramount.
for more details
JNC 7 in pdf formathttp://www.nhlbi.nih.gov/guidelines/hypertension/express.pdf
JNC 7 slideset