Summary: NR566 Week 3
JNC8 Guidelines for Hypertension
Define the classes of hypertension (normal, elevated, stage 1 & stage 2) according to each
guideline.
o The JNC-8 guidelines does not provide definition on the classes of hypertension.
However, just for reference, the JNC-7 guidelines did provide classification on
hypertension (James et al., 2014):
Normal: < 120 mmHg systolic, and < 80mmHg diastolic
Prehypertension: 120-139 mmHg systolic and 80-89 mmHg diastolic
Stage 1: 140-159 mmHg systolic and 90-99 mmHg diastolic
Stage 2: >160 mmHg systolic and > 100 mmHg
What are the thresholds for initiating treatment?
o Per the JNC-8 guidelines (2014), the first recommendation is that treatment should be
initiated on those adults over the age of 60 and who have a systolic blood pressure
greater than 150 mmHg and diastolic blood pressure greater than 90 mmHg. The second
recommendation is for the population under the age of 60, if their diastolic blood
pressure has reached 90 mmHg or higher, then pharmacological treatment is
recommended. Furthermore, the third recommendation is also for people under the age
of 60, and whose diastolic blood pressure has reached over 140 mmHg, pharmacological
treatment should be initiated as well (James et al., 2014).
What are the treatment goals? (Hint: there may be multiple treatment goals based on certain
populations such as diabetics)
o The JNC-8 guideline treatment goals are as follows:
The corollary recommendation under the first recommendation, is for the
population over 60 years, if their diastolic blood pressure has reached 140
mmHg or less, and patient is able to tolerate medications well, then treatment
does not need to be adjusted (James et al., 2014).
The fourth JNC-8 recommendation is for people who are 18 years or older and
have chronic kidney disease (CKD), their treatment goal is to reach under 140
mmHg diastolic and under 90 mmHg systolic (James et al., 2014).
The fifth JNC-8 recommendation is for people who are 18 years or older and
have diabetes, their goal is also to reach under 140 mmHg diastolic and under
90 mmHg systolic (James et al., 2014).
What medications are recommended to treat hypertension in the African American
population?
o The seventh JNC-8 recommendation, references that the African American population’s
pharmacological treatment should include ACE-Inhibitors or Angiotensin II Receptor
Blockers (ARBs) in order to promote kidney function (James et al., 2014).
JNC8 Guidelines for Hypertension
Define the classes of hypertension (normal, elevated, stage 1 & stage 2) according to each
guideline.
o The JNC-8 guidelines does not provide definition on the classes of hypertension.
However, just for reference, the JNC-7 guidelines did provide classification on
hypertension (James et al., 2014):
Normal: < 120 mmHg systolic, and < 80mmHg diastolic
Prehypertension: 120-139 mmHg systolic and 80-89 mmHg diastolic
Stage 1: 140-159 mmHg systolic and 90-99 mmHg diastolic
Stage 2: >160 mmHg systolic and > 100 mmHg
What are the thresholds for initiating treatment?
o Per the JNC-8 guidelines (2014), the first recommendation is that treatment should be
initiated on those adults over the age of 60 and who have a systolic blood pressure
greater than 150 mmHg and diastolic blood pressure greater than 90 mmHg. The second
recommendation is for the population under the age of 60, if their diastolic blood
pressure has reached 90 mmHg or higher, then pharmacological treatment is
recommended. Furthermore, the third recommendation is also for people under the age
of 60, and whose diastolic blood pressure has reached over 140 mmHg, pharmacological
treatment should be initiated as well (James et al., 2014).
What are the treatment goals? (Hint: there may be multiple treatment goals based on certain
populations such as diabetics)
o The JNC-8 guideline treatment goals are as follows:
The corollary recommendation under the first recommendation, is for the
population over 60 years, if their diastolic blood pressure has reached 140
mmHg or less, and patient is able to tolerate medications well, then treatment
does not need to be adjusted (James et al., 2014).
The fourth JNC-8 recommendation is for people who are 18 years or older and
have chronic kidney disease (CKD), their treatment goal is to reach under 140
mmHg diastolic and under 90 mmHg systolic (James et al., 2014).
The fifth JNC-8 recommendation is for people who are 18 years or older and
have diabetes, their goal is also to reach under 140 mmHg diastolic and under
90 mmHg systolic (James et al., 2014).
What medications are recommended to treat hypertension in the African American
population?
o The seventh JNC-8 recommendation, references that the African American population’s
pharmacological treatment should include ACE-Inhibitors or Angiotensin II Receptor
Blockers (ARBs) in order to promote kidney function (James et al., 2014).
