Hipertenion is the main factor preventable in disease and death in the United States, which contribute to stroke, kidney disease and heart attacks.It is imperative to detect it early and treat it to prevent serious complications. Prevention, detection, evaluation and treatment of high blood pressure issued recommendations based on scientific evidence.What is JNC 8?
You may have heard that you have to control high blood pressure in adults. These recommendations were published by the 8th joint national committee for the prevention, detection, evaluation and treatment of high blood pressure, known as JNC 8.The guidelines were created after the Committee of Experts is synthesized through all available scientific evidence, and have been updated to provide guidance for health care providers to administer hypertension .JNC 8 recommends the thresholds for the treatment of high blood pressure, arterial pressure purposes and medicinal therapy according to the actual data.
Blood pressure thresholds and goals
Study that reduced blood pressure in adults with hypertension in 10 mm HG can reduce the risk of death from cardiovascular disease and strokeby 25% to 40%. The evidence shows that adults, such as 60, should start medications when reading systolic blood pressure (higher number) is of 140 mm Hg., or up or by reading diastolic arterial The pressure is 90 mm.hg or higher.Adults over 60 years of treatment should begin if the systolic pressure is 150 mm Hg., Or higher, and if the diastolic pressure is 90 mm Hg. Patients who start in treatment should use these numbers for objective purposes.People who have diabetes or chronic illness should also use these objectives, since JNC 8 did not find evidence that the maintenance of lower blood pressure improves health outcomes in these two groups.
Recommendations for medications for the initial treatment
JNC 8 has changed the recommendations for medications for the initial treatment of hypertension,Of 5 classes of drugs up to 4 recommended classes.JNC 8 Recommendations for exquisite treatment of up to four classes of drugs:
- Enzyme inhibitors Conversion of angiotensink (ACEI)
- Angiotensin receptor blockers (ARB)
- blockersOf calcium channels (CCB)
JNC 8 also carefully considered the tests to make a specific advice on drug-based subgroups. The presence of diabetes or chronic kidney disease .There is enough evidence that there are racial differences in the reaction to certain general classes of medication against blood pressure.Final recommendations:
- The total non-temporary population (with diabetes or without or without or without or without it) should start with ACEI, ARB, CCB or Diuretics Tiazid therapy (ie ,,Hydrochlorothiazide)
- The common black population (with or without diabetes) must use a diuretic or thiazide CCB for the initial processing of hypertension.
- Patients with chronic kidney disease over 18 should use ACEI or ARB as initial therapy or supplement to the therapist to improve the results of the kidneys. This refers to black and not black populations.
When the dose increases or add a new medication
JNC 8 recommends to increase the original dose or add a second preparation of one of the recommended drug classes for your subgroup,If you can not achieve the goal of blood pressure during the month.If the increase in dose or add a new medication does not reduce blood pressure to its target objective, your health care provider should add a third preparation of one of the recommended classes. However, Aceis and ARB should not be used together.Some patients may require the application for the drug for another class.
Other kinds of antihypertoleous medications
There are times when patients have another reason to take a class medication, which is specifically mentioned in JNC 8 recommendations.For example, it was demonstrated that beta blockers improve survival in patients with heart failure, so they are a good option to reduce blood pressure in patients with stagnant heart failure.Patients with benign prostate hypertrophy often take the kind of drugs known as alpha blockers to reduce their symptoms.These medications were originally designed to treat high blood pressure, but also relax the neck of the prostate and bladder, allowing urine to flow freely.Falph blockers are a good option for the treatment of hypertension in men with BPH.