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2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults
JAMA ^ | February 5, 2014 | Paul A. James et al.

Posted on 03/10/2014 6:59:25 PM PDT by neverdem

Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) FREE

Hypertension is the most common condition seen in primary care and leads to myocardial infarction, stroke, renal failure, and death if not detected early and treated appropriately. Patients want to be assured that blood pressure (BP) treatment will reduce their disease burden, while clinicians want guidance on hypertension management using the best scientific evidence. This report takes a rigorous, evidence-based approach to recommend treatment thresholds, goals, and medications in the management of hypertension in adults. Evidence was drawn from randomized controlled trials, which represent the gold standard for determining efficacy and effectiveness. Evidence quality and recommendations were graded based on their effect on important outcomes.

There is strong evidence to support treating hypertensive persons aged 60 years or older to a BP goal of less than 150/90 mm Hg and hypertensive persons 30 through 59 years of age to a diastolic goal of less than 90 mm Hg; however, there is insufficient evidence in hypertensive persons younger than 60 years for a systolic goal, or in those younger than 30 years for a diastolic goal, so the panel recommends a BP of less than 140/90 mm Hg for those groups based on expert opinion. The same thresholds and goals are recommended for hypertensive adults with diabetes or nondiabetic chronic kidney disease (CKD) as for the general hypertensive population younger than 60 years. There is moderate evidence to support initiating drug treatment with an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, calcium channel blocker, or thiazide-type diuretic in the nonblack hypertensive population, including those with diabetes. In the black hypertensive population, including those with diabetes, a calcium channel blocker or thiazide-type diuretic is recommended as initial therapy. There is moderate evidence to support initial or add-on antihypertensive...

(Excerpt) Read more at jama.jamanetwork.com ...


TOPICS: Culture/Society; News/Current Events
KEYWORDS: bloodpressure; health; highbloodpressure; hypertension; medicine

1 posted on 03/10/2014 6:59:25 PM PDT by neverdem
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To: neverdem

Part of the plot against MAWGs? First they took away PSA tests to see how many they could kill with prostate cancer; now it looks like they want to limit blood pressure medication (much of which is now available in cheap generic form.


2 posted on 03/10/2014 7:02:47 PM PDT by PAR35
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bkmk


3 posted on 03/10/2014 7:08:07 PM PDT by smokingfrog ( sleep with one eye open (<o> ---)
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To: neverdem

Anybody who falls for JAMA b/s is truly foolish! NEJM is slightly more intelligent..like “dumb” to “stupid” comparison and the fact that Zero owns webmd is truly frightening.
Medicalnacht…anyone?!!!


4 posted on 03/10/2014 7:08:21 PM PDT by acapesket
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To: neverdem

I had a nice steady blood pressure of around 162 over 102 for a couple of years and stopped drinking. After two weeks, no change. After two months, I was right in the middle of “normal”. We thought the machine was broken so we took several readings of me and my wife.

But it was true. And all that that implies.


5 posted on 03/10/2014 7:09:06 PM PDT by cuban leaf
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To: neverdem

My BP is 95/69. In my younger days it was 90/60 or worse. I used to pass out a lot.


6 posted on 03/10/2014 7:24:23 PM PDT by Excellence (All your database are belong to us.)
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To: sauropod

.


7 posted on 03/10/2014 7:25:57 PM PDT by sauropod (Fat Bottomed Girl: "What difference, at this point, does it make?")
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To: PAR35
Don't think this has gone unnoticed by doctors.

Obamacare's "experts" know exactly what they are doing.

You're OLD?

No medicine for you!

Part of the softening up of the public for accepting "less" in the way of medical care.

It's the New Normal.

Just like in Europe.

8 posted on 03/10/2014 7:30:09 PM PDT by boop (I just wanted a President. But I got a rock.)
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To: neverdem

In the past 5 years, my BP went from 110-120/80 to (with the home devices) 160/115! WTF?


9 posted on 03/10/2014 7:36:45 PM PDT by Captainpaintball
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To: cuban leaf

The cure is worse than the disease. Good health is very important but sanity more so.


10 posted on 03/10/2014 7:38:49 PM PDT by huckfillary
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To: cuban leaf

I’m a little dense, but you are implying your cutting drinking caused your BP to go back to normal. Did you stop completely? What did you drink before? I guess I started drinking more in the last 5 years, but that would equal less than one Guinness / glass of red wine per day. I can’t imagine that’s what made mine jump from 120/90-160/115.


11 posted on 03/10/2014 7:40:36 PM PDT by Captainpaintball
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To: Captainpaintball

42 yo, 5’9” male. 220lbs. On BP meds amplodipine, 5mg after checkup. Was 160/110 . Doc told me to lose 20 lbs and exercise 10-20 mins three times a day.


12 posted on 03/10/2014 7:53:24 PM PDT by DCBryan1 (No realli, moose bytes can be quite nasti!!)
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To: DCBryan1
Was 160/110 . Doc told me to lose 20 lbs and exercise 10-20 mins three times a day.

It's crazy. I do that, and more. Who knows...Time to find a new doctor, and get on the generic crestor, or whatever they are giving out free at the supermarket with prescription...

13 posted on 03/10/2014 8:00:36 PM PDT by Captainpaintball
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To: DCBryan1

45 yo male. 260lbs. 5’10”.

I deadlift in the 500’s, bench in the 400’s, and I workout four days a week for an hour a session.

Could stand to lose twenty pounds. But I’d look even more,like monster if I did. Doc said most people don’t bother. Has me on Lisinop/HCTZ.

Went from 165/107 to 116/85.

Dad had similar issues minus the weightlifting hobby...


14 posted on 03/10/2014 8:07:41 PM PDT by Dead Corpse (Tre Norner eg ber, binde til rota...)
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To: huckfillary

The cure is worse than the disease. Good health is very important but sanity more so.


I did go back to drinking, but less and more as a special thing. It’ like eating big macs once a month instead of every day for lunch.


15 posted on 03/10/2014 11:43:50 PM PDT by cuban leaf
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To: Captainpaintball

I’m a little dense, but you are implying your cutting drinking caused your BP to go back to normal. Did you stop completely?


Yes, completely. And I was getting to the point where I would drink at least one oz of liquor a night, if not two. And I also went to a fairly sedentary (for me) lifestyle when we moved to ky, believe it or not. In Seattle I bicycle commuted every day and did stuff like the 200 mile seattle to portland bike ride in one day every year. I’ve only put my butt in the saddle out here twice in almost three years.

But completely stopping alcohol consumption, with no other lifestyle change, brought my BP to rock solid normal.


16 posted on 03/10/2014 11:47:05 PM PDT by cuban leaf
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To: PAR35

they have been pushing us to lower blood pressure way down for years (120), and most of us have done some of this, but noticed our older patients got faint, so we sort of let their pressure up to 140. Now they are catching up to what we have done out of common sense.

The bad news? They are pushing cheap diuretics (water pills)... ten percent of men taking them get problems in their love life, but what they hey: they’re cheap!


17 posted on 03/11/2014 1:05:51 AM PDT by LadyDoc (liberals only love politically correct poor people)
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To: cuban leaf
But completely stopping alcohol consumption, with no other lifestyle change, brought my BP to rock solid normal.

Crap! (for me-I am happy for you)

18 posted on 03/11/2014 1:23:53 AM PDT by Captainpaintball
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To: acapesket
"Report From the Panel Members Appointed to the Eighth Joint National Committee"

Anybody who falls for JAMA b/s is truly foolish!

What does that have to do with JAMA other than JAMA made the report FReebie?

Do you have any formal training in any science or medicine besides reading assorted paranoid anecdotes from the internet?

19 posted on 03/11/2014 11:01:29 AM PDT by neverdem (Register pressure cookers! /s)
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To: Captainpaintball

0bama’s fault


20 posted on 03/11/2014 5:09:45 PM PDT by smokingfrog ( sleep with one eye open (<o> ---)
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To: smokingfrog

Ha! The coincidence is undeniable!


21 posted on 03/14/2014 2:42:33 PM PDT by Captainpaintball
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To: Dead Corpse

Was it the drugs or the exercise regimen that reduced your blood pressure?


22 posted on 03/16/2014 6:24:25 AM PDT by 1010RD (First, Do No Harm)
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To: LadyDoc

Are you saying that blood pressure moves up normally/naturally with age?


23 posted on 03/16/2014 6:26:16 AM PDT by 1010RD (First, Do No Harm)
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To: cuban leaf
But completely stopping alcohol consumption, with no other lifestyle change, brought my BP to rock solid normal.

There was another factor...moving from a 'blue state' or a 'blue region' like Soviet Red England to a 'red state/region' can lower your blood pressure, as well. :-)

I expect mine to drop twenty points on both ends when I leave Red Hampshire for Tennessee. The daily feeling of nausea in the pit of my stomach will disappear, as well.

24 posted on 03/16/2014 6:34:37 AM PDT by who knows what evil? (Yehovah saved more animals than people on the ark...www.siameserescue.org.)
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To: 1010RD

Drugs...

Still looking at other factors. This runs in my family though.


25 posted on 03/16/2014 7:31:11 AM PDT by Dead Corpse (Tre Norner eg ber, binde til rota...)
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To: who knows what evil?

Man, looking back in hindsight I don’t know if Kentucky is better than Tennessee or vice versa. Both has it’s benefits and both are far better than living in a blue state.


26 posted on 03/16/2014 9:19:14 AM PDT by cuban leaf
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To: cuban leaf

Amen...either Kentucky or Tennessee are far better than any damn ‘blue state’.


27 posted on 03/16/2014 10:33:56 AM PDT by who knows what evil? (Yehovah saved more animals than people on the ark...www.siameserescue.org.)
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To: 1010RD
blood pressure per se does not move upward with age, but the blood vessels are less elastic when you age.

In young people, when the heart pumps, they “balloon” up and then, like a balloon losing air, go back to normal size. This keeps the average pressure higher.

But in the elderly, their blood vessels are stiff, and don't balloon up and down... so you need a higher top number to keep the average pressure good enough to keep the blood going to the brain. Lower the pressure too much, and they stand up and faint, or don't get enough blood to their brain and turn “senile”.

On the other hand, if it gets too high you are also at risk of blowing out the stiff blood vessels. So you don't want the top number too high.

For awhile, there was a push to get everyone down to 120 top number. That was too low for many people. Now it looks like they won't try to get it lower than 140 in the older folks.

And all of this is why people argue if you should go by the top number, bottom number, or average. The answer: All three...it depends.

To complicate things more: a thin young pregnant girl can have severe high blood pressure/toxemia problems if her pressure is 120/100.

28 posted on 03/17/2014 10:36:25 PM PDT by LadyDoc (liberals only love politically correct poor people)
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