The Eighth Joint National Committee (JNC8) has finally published updated hypertension guidelines more than 10 years since the JNC7. The guidelines raise the blood pressure (BP) treatment threshold for otherwise healthy adults aged 60 or older from a systolic BP of 140 mmHg to 150 mmHg. Treatment thresholds for diabetics or those with chronic kidney disease (CKD) remain at 140 mmHg, and the threshold of treatment of diastolic BP remains at 90 mmHg for all patients. The JNC7 recommended initial therapy with thiazide-type diuretics for most patients while the JNC8 recommends initial therapy with thiazides, calcium channel blockers (CCBs), angiotensin-converting enzyme (ACE) inhibitors, or angiotensin-receptor blockers (ARBs) for nonblack patients. For black patients, initial therapy should be a thiazide or a CCB. For all patients with CKD, initial therapy should include an ACE inhibitor or an ARB (JAMA published online December 18, 2013. Doi:10.1001/jama.2013.284427).
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