Hypertension Guidelines Review: JNC 8 vs. ACC/AHA

This flashcard set compares the JNC 8 and ACC/AHA hypertension guidelines, covering diagnostic thresholds, treatment stages, and blood pressure goals.

JNC

The Joint National Committee, which publishes evidence-based guidelines on the prevention, diagnosis, and management of hypertension.

JNC 8 Hypertension Diagnosis

A blood pressure measurement of $140/90\,mmHg$ or greater.

JNC 8 Pharmacological Treatment Threshold (Age $\ge 60$)

Initiate treatment when blood pressure increases to $\ge 150/90\,mmHg$.

JNC 8 Pharmacological Treatment Threshold (Age $< 60$)

Initiate treatment when blood pressure is $\ge 140/90\,mmHg$.

JNC 8 Treatment Goal

Decrease blood pressure to below $140/90\,mmHg$.

Normal Blood Pressure (ACC/AHA)

Any reading below $120/80\,mmHg$.

Elevated Blood Pressure (ACC/AHA)

A systolic blood pressure of $120-129\,mmHg$ and a diastolic blood pressure of less than $80\,mmHg$.

Stage 1 Hypertension (ACC/AHA)

A systolic blood pressure of $130-139\,mmHg$ or a diastolic blood pressure of $80-89\,mmHg$.

Stage 2 Hypertension (ACC/AHA)

Anything greater than or equal to $140\,mmHg$ systolic or greater than or equal to $90\,mmHg$ diastolic.

Diagnosis Requirement (ACC/AHA)

Requires at least two blood pressure readings taken on two separate occasions.

Lifestyle Modifications

Interventions including a low sodium diet, exercise, weight loss, smoking cessation, and limiting alcohol intake.

ASCVD

Atherosclerotic cardiovascular disease.

ASCVD Risk Threshold (Stage 1)

A risk score of $10\%$; used to determine if medication should be started immediately for Stage 1 hypertension.

ACC/AHA Stage 1 Treatment (Low Risk)

Trial lifestyle modifications for $3\text{ to }6\,months$ if the ascvd risk score is less than $10\%$ and no other cardiovascular risk factors are present.

ACC/AHA Stage 1 Treatment (High Risk)

Initiate medication immediately if the ascvd risk score is greater than $10\%$ or if there is a clinical diagnosis of cardiovascular disease.

ACC/AHA Stage 2 Treatment

Start medication right away while encouraging concurrent lifestyle modifications.

Medication Reassessment Timeline

Reassess the patient about $1\,month$ after starting medication to check adherence and effectiveness.

ACC/AHA Blood Pressure Goal

Decrease blood pressure to less than $130/80\,mmHg$.