New Guidelines to Simplify Hypertension Treatment

The American Society of Health-Systems Pharmacists reported in February that a group appointed by the National Heart, Lung and Blood Institute, the Eighth Joint National Committee (JNC 8), released its guidelines regarding the treatment of hypertension.

In addition, a panel endorsed by the American Society of Hypertension and the International Society of Hypertension (ASH-ISH) released its own guidelines about the same time as the JNC 8.

As a result, pharmacists and other clinicians now have two treatment guidelines when it comes to treating hypertension.

When it comes to recommended systolic and diastolic blood pressure readings, both sets of guidelines believe that the best goal is <140 mm HG for systolic and <90 mm HG for diastolic. These recommendations are for adults and includes those who have chronic kidney disease or diabetes.

This is a change from the JNC 8 panel back in 2003, which had set lower blood pressure goals for those patients with pre-existing conditions. The panel is reported to have reviewed data from “high-quality randomized, controlled clinical trials” that looked at questions regarding managing hypertension. The process to develop the new guidelines followed the recommendations made by the Institute of Medicine in 2011.

The guidelines set forth by the ASH-ISH come from an effort to help individuals with hypertension who live in “low-resource countries.” The recommendations come from studies that looked at non-random and uncontrolled trials.

The ASH-ISH guidelines are to be used within community practice and offer practical tips for diagnosing hypertension and performing physical exams. It also includes a section on hypertension in those of African ancestry.

Perhaps the main difference between the two sets of guidelines is how they diverge when it comes to older patients (age 80 and older) without pre-existing conditions.

The ASH-ISH’s guidelines recommendations are for patients older than 80, while the JNC 8’s guidelines are for those aged 60 and up.

The American Heart Association reports that as many as one-third of all people in the United States have hypertension, with about two-thirds of adults older than 60 having the condition. The risk does rise as one ages.

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