JNC 8: Raising the Blood Pressure (and Ire) of Many

The Joint National Committee (JNC) 8 guideline (published online in late December 2013 and printed in a February 2014 issue of JAMA) addresses blood pressure (BP) thresholds at which drug therapy should be initiated, BP targets during hypertensive treatment, and choice of antihypertensive agents (NEJM JW Gen Med Dec 24 2013).

For patients younger than 60, JNC 8 specifies that drug therapy should be considered when diastolic BP is >90 mm Hg or systolic BP is >140 mm Hg. For older patients (age, ≥60), the diastolic BP threshold remains >90 mm Hg, but the systolic BP threshold is >150 mm Hg. Among people with diabetes or chronic renal disease, the threshold to initiate drug therapy is 140/90 mm Hg, and the goal for treatment is <140/90.

In black…