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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
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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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