Hypertension Guidelines: 2021 USPSTF Recommendation, 2018 ESC/ESH, 2017 ACC/AHA, and the 2014 JNC8 guideline. (2024)

Table of Contents

Journals 2021 USPSTF Recommendation: Screening for Hypertension inAdults 2018 ESC/ESH Guideline 2017 ACC/AHA Hypertension Guideline 2014 Guideline JAMA Patient Pages FAQs References

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2021 USPSTF Recommendation: Screening for Hypertension inAdults

In 2021, the US Preventative Services taskforce issued a new recommendation statement on screening for hypertension in adults. The statement reaffirms the 2015 USPSTFrecommendation concluding with high certainty that screening for hypertension in adults has substantial net benefit.

2021 Hypertension GuidelineScreening for Hypertension in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

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See Also
AAIM Principles and Recommendations for the 2021-2022 Internal Medicine Residency Interview Cycle in Response to the Continued COVID-19 Pandemic Internal Medicine Clinical Practice Guidelines

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April 27, 2021 | 18 min 8 sec

USPSTF Recommendation: Screening for Hypertension in Adults Download MP3

Review and Patient Information

Evidence Report
JAMA Patient Page
Screening for Hypertension in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force JAMA | April 27, 2021
Screening for Hypertension in Adults JAMA | April 27, 2021

2018 ESC/ESH Guideline

In 2018 the ESC/ESH published a guideline which retains the 140/90 threshold definition of hypertension, including for patients with chronic kidney disease(CKD), and emphasizes lifestyle interventions as primary treatment, with consideration of antihypertensive drug therapy only in adults at very high risk, eg with established CVD. In many other respects the 2018 guidelineis similar to the 2017 ACC/AHAguideline.

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November 6, 2018 | 32 min 27 sec

Battle of the Heart Societies: Who Is Right--the US or Europe--Regarding How to Manage Hypertension? Download MP3
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November 6, 2018 | 32 min 25 sec

Battle of the Heart Societies Part 2: Who Is Right--the US or Europe--Regarding How to Manage Hypertension? Download MP3

2017 ACC/AHA Hypertension Guideline

In 2017 the ACC/AHA and 9 other specialty organizations published an updated hypertension guideline which, among manychanges, redefined elevated blood pressure to lower BP levels, enlarging the population considered potential candidates for monitoring andtreatment. Learn morehere.

Research, Reviews, and Commentary

Research and Review
Opinion
Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults JAMA | JAMA Clinical Guidelines Synopsis | December 5, 2017
The 2018 European Society of Cardiology/European Society of Hypertension and 2017 American College of Cardiology/American Heart Association Blood Pressure Guidelines: More Similar Than Different JAMA | Viewpoint | November 6, 2018
Prevalence of Hypertension, Treatment, and Blood Pressure Targets in Canada Associated With the 2017 American College of Cardiology and American Heart Association Blood Pressure Guidelines JAMA Network Open | Original Investigation | March 8, 2019
Blood Pressure Control—Much Has Been Achieved, Much Remains to Be Done JAMA Cardiology | Editorial | May 23, 2018
Media Coverage of the Benefits and Harms of the 2017 Expanded Definition of High Blood Pressure JAMA Internal Medicine | Research Letter | December 28, 2018
The New Hypertension Guidelines: Compelling Population Benefit, Manageable Risk, and Time to Implement JAMA Cardiology | Editor's Note | May 23, 2018
Association of Blood Pressure Classification in Young Adults Using the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline With Cardiovascular Events Later in Life JAMA | Original Investigation | November 6, 2018
Incremental Benefits and Harms of the 2017 American College of Cardiology/American Heart Association High Blood Pressure Guideline JAMA Internal Medicine | Editorial | April 16, 2018
Association of Blood Pressure Classification in Korean Young Adults According to the 2017 American College of Cardiology/American Heart Association Guidelines With Subsequent Cardiovascular Disease Events JAMA | Original Investigation | November 6, 2018
The 2017 Hypertension Guideline: What’s New and Different JAMA | Viewpoint | November 20, 2017

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May 23, 2018 | 19 min 6 sec

Association of the 2014 and 2017 Hypertension Guidelines With Cardiovascular Events and Deaths in US Adults Download MP3
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December 5, 2017 | 39 min 43 sec

Managing Hypertension Part 1: Understanding the New AHA/ACC Hypertension Guideline Download MP3
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December 12, 2017 | 10 min 37 sec

Managing Hypertension Part 2: Understanding the New AHA/ACC Hypertension Guideline Download MP3

2014 Guideline

In 2014, panel members of the Eighth Joint National Committee published the results of their evidence review and deliberations about the prevention, detection, evaluation, and treatment of high bloodpressure.

The 2014 guideline offers recommendations for the management of hypertensionin:

People older or younger than age 60 years
People aged ≥18 years with chronic kidney disease
People aged ≥18 years with diabetes
Black and nonblack populations

2014 Hypertension Guideline2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)

Treatment Algorithm

Appendix

Past JNC Reports:JNC7 | JNC6 | JNC5 |JNC4 | JNC3 |JNC2 |JNC1

Research, Reviews, and Commentary

Related Editorials
Post-Publication Peer Review
Assessing the Trustworthiness of the Guideline for Management of High Blood Pressure in Adults JAMA | Editorial | February 5, 2014
Guidelines for Managing High Blood Pressure JAMA | Comment & Response | July 16, 2014
Recommendations for Treating Hypertension: What Are the Right Goals and Purposes? JAMA | Editorial | February 5, 2014
Guidelines for Managing High Blood Pressure JAMA | Comment & Response | July 16, 2014
Updated Guidelines for Management of High Blood Pressure: Recommendations, Review, and Responsibility JAMA | Editorial | February 5, 2014
Guidelines for Managing High Blood Pressure JAMA | Comment & Response | July 16, 2014
Hypertension—A Public Health Challenge of Global Proportions JAMA | Editorial | November 6, 2018
Guidelines for Managing High Blood Pressure—Reply JAMA | Comment & Response | July 16, 2014

Audio and Video

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December 18, 2013 | 22 min 57 sec

2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) Download MP3
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Oct 29, 2015 | 60 min 18 sec

WIHI: How High? How Low? Shared Decision Making Amidst Shifting (Hypertension) Guidelines Download MP3

The JAMA Report: Proportion of US Adults Potentially Affected by the 2014 HypertensionGuideline

Author Interview: Proportion of US Adults Potentially Affected by the 2014 HypertensionGuideline

JAMA Patient Pages

New Guideline for Treatment of High Blood Pressure in Adults
Salt Restriction
Hypertension
Retinopathy
I Have High Blood Pressure: What Do I Need to Know?
Monitoring Blood Pressure Outside of the Doctor's Office

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Hypertension Guidelines: 2021 USPSTF Recommendation, 2018 ESC/ESH, 2017 ACC/AHA, and the 2014 JNC8 guideline. (2024)

FAQs

What are the JNC 8 and ACC 2017 hypertension guidelines? ›

Hypertension control referred to an average SBP < 130 & DBP < 80 mmHg based on the 2017 ACC/AHA and an average SBP < 140 & DBP < 90 mmHg based on the JNC8.

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What is the JNC 8 guideline for hypertension? ›

JNC 8 Recommendations 2 to 5

In all persons <60 years or in persons >18 years (and either those younger or older than 60 years with either diabetes or CKD), initiate pharmacologic treatment to lower SBP ≥140 or DBP ≥90 mm Hg and treat to a goal BP of <140/90 mm Hg.

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What are the ACC AHA hypertension guidelines for 2021? ›

Blood pressure categories in the new guideline are:

Normal: Less than 120/80 mm Hg;
Elevated: Systolic between 120-129 and diastolic less than 80;
Stage 1: Systolic between 130-139 or diastolic between 80-89;
Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;

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Nov 13, 2017

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What is the 2018 AHA ACC guideline for hypertension? ›

A target blood pressure of less than 130/80 mm Hg is recommended for adults with confirmed hypertension and cardiovascular disease, or a 10-year atherosclerotic cardiovascular disease risk of 10% or more.

Learn More Now ›

What is the difference between JNC 7 and JNC 8 hypertension classification? ›

The JNC7 recommended different treatment goals for patients with “uncomplicated” hypertension and those with other comorbid conditions like diabetes and chronic kidney disease while a treatment goal of < 140/90 mmHg was recommended for all hypertensive populations by the JNC 8.

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What does JNC 8 stand for? ›

With the release of the Eighth Joint National Committee on Prevention, Detection, Evaluation, and Treatment (JNC-8) guidelines, there have been major changes in blood pressure management in the various subgroups.

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What is the JNC 8 controversy? ›

The first and perhaps most controversial was the move to raise the threshold for initiating pharmacologic therapy in those aged 60 years and older to a systolic blood pressure of 150 mmHg, aiming to treat to a goal below 150 mmHg (instead of 140 mmHg in JNC-7).

Get More Info Here ›

What are the newest JNC guidelines? ›

Summary

Treat hypertensive persons aged > 60 to a BP goal < 150/<90 mm Hg; and hypertensive persons 30 through 59 years of age to BP goal of < 140/<90.
Use the same treatment thresholds for people with diabetes and those without diabetes < 60 with CKD.

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Mar 11, 2024

What is hypertension according to AHA? ›

High blood pressure (BP), or hypertension, is defined by two levels by the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines ^[¹^, ²^] : (1) elevated BP, with a systolic pressure (SBP) between 120 and 129 mm Hg and diastolic pressure (DBP) less than 80 mm Hg, and (2) stage 1 hypertension, ...

What is the latest definition of hypertension? ›

Hypertension (high blood pressure) is when the pressure in your blood vessels is too high (140/90 mmHg or higher).

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What is hypertension guidelines ACC 2017? ›

Recommendations for antihypertensive medication initiation according to the 2017 ACC/AHA blood pressure guideline include SBP between 130 and 139 mm Hg or DBP between 80 and 89 mm Hg with diabetes, chronic kidney disease, a history of CVD, or a 10-year predicted CVD risk ≥10%, or age ≥65 years with SBP ≥130 mm Hg.

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What is normal blood pressure by age? ›

What Is Normal Blood Pressure Level by Age?

	Women	Men
18-39 years	110/68 mm Hg	119/70 mm Hg
40-59 years	122/74 mm Hg	124/77 mm Hg
60+ years	139/68 mm Hg	133/69 mm Hg

Nov 4, 2022

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What is the cut off for hypertension? ›

The current definition of hypertension (HTN) is systolic blood pressure (SBP) values of 130 mm Hg or more and/or diastolic blood pressure (DBP) of more than 80 mm Hg.

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What is the 2017 ACC AHA blood pressure treatment guideline? ›

Among adults taking antihypertensive medication, the 2017 ACC/AHA guideline recommend an SBP treatment target goal of <130 mmHg. Also, a DBP treatment target goal of <80 mmHg is recommended for adults <65 years of age and those ≥ 65 years of age with diabetes, CKD, a history of CVD or a 10-year predicted CVD risk ≥10%.

What is the high blood pressure Clinical Practice Guideline 2017? ›

Hypertension in the new guideline is now defined as a blood pressure above 130/80 mmHg for anyone at risk of heart attack or stroke. Elevated blood pressure is defined as >120/80 mmHg. Notably, treatment recommendations are now personalized; they are based on an individuals' underlying cardiovascular disease risk.

Get More Info Here ›

What are the new hypertension guidelines JNC 7? ›

According to JNC 7, the general BP goal is to lower systolic BP to less than 140 mm Hg and diastolic BP to less than 90 mm Hg. This recommendation is supported by many clinical trials. A more aggressive goal of less than 130/80 mm Hg is advised for patients with diabetes or chronic kidney disease.

Get More Info ›

What is the criteria for hypertension in 2024? ›

Hypertension is defined as having systolic blood pressure (SPB) ≥140 mmHg or diastolic blood pressure (DPB) ≥90 mmHg.

Learn More Now ›