Jnc 7 pdf download

Wright has received honoraria for serving as a Ph. Manger, M. Materson, M. Stanford Claude Lenfant, M. Marvin Moser, M. Yale University School of Bakris, M. Rush D. National Center for M. Birmingham, AL ; Otelio S. Randall, M. University of Iowa, F. Chesley, Jr. Washington, DC ; James W. Reed, M. Cohen, M. Louis, Ph. Colman, D. Veterans Affairs Sheldon G. Sheps, M. Rochester, MN ; David B. Snyder, R. Cziraky, Pharm. Health Core, Inc. Davis, P. Sowers, M. Gifford, Jr. Cleveland Ronald Stout, M.

Strickland, Michael Glick, D. New Jersey Dental Ed. Baylor College of Medicine, Houston, F. Weiss, M. Washington, DC ; Thomas G. Pickering, M. Michael Prisant, M. Wilson, M. Somers, M. Mayo Clinic Pressure and Cholesterol, Inc. American Heart Townsend, M. Vidt, M. The University of Jan N. Basile, M. Cleeman, M. American Darla E. Danford, M. Dart, M. Donato, S. National Heart, M. Dunlap, M. Egan, M. Falkner, M. American Academy of Ophthalmology Flack, M. Gorelik, M.

Hand, M. Hershey, M. Kaplan, M. Lohr, M. Hypertension Education Foundation, Inc. National Hypertension Association, Inc. National Kidney Foundation, Inc. Contents Foreword. Trends in awareness, treatment, and control of high blood pressure, — Changes in blood pressure classification. Classification of blood pressure for adults. Recommendations for followup based on initial blood pressure measurements for adults without acute end organ damage.

En algunos. Figura 1. Fuente: et al. Frecuencia de muertes ajustadas por edad hasta Figura 4. Chart 3— Accessed September El incremento relacionado con la edad en la PAS es el primer responsable del incremento de la incidencia y prevalencia de la HTA al aumentar la edad Figura 5.

Figure 1. Accessed September, Wolz and T. June Figura 8. Figura 9. La presencia de cada factor de riesgo adicional el impresionante incremento en las complicaciones del riesgo conforma el riesgo de HTA, como se ilustra en la Figura 12 El aumento de la los dos grupos Tabla 2. Figura La los mmHg 30, En el importantes en los EEUU.

Un estudio de consumo de alcohol 10, Fuente: N Engl J Med ;— Tabla 2. Fuente: K. Andersos, P. Odell, W. An updated coronary risk profile. High blood pressure remains a leading public health threat. It is a primary risk factor for cardiovascular disease and its prevention Guidelines for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary 2. Adults vs. JNC-7 takes into account many of the randomized controlled trials dealing with hypertension published over the past few years, and thus, is very much up to date.

Some highlights of the report are as follows. Jnc 8 hypertension guidelines algorithm. Jnc 7 high blood pressure. Practice guidelines for the. Jnc 8 and more hypertension guidelines from the eighth joint. A step by step algorithm to hypertension management. The eighth joint national committee jnc 8. JNC 1 was eight pages and described 24 drugs available for use.

JNC 7,. The JNC-7 guidelines suggested that diastolic blood pressure DBP should not be aggressively lowered below 55 to 60 mm Hg because of possible increase in cardiovascular events associated with lower values pages and of the report.

Consumption of drinks This suggests that the results of ALLHAT are not com- per day may decrease SBP; however, more than 2 drinks pletely generalizable to the everyday practice of medicine.

The guidelines recom- Side effects of thiazide diuretics include hypokalemia, hyper- mend that men limit alcohol consumption to 2 drinks uricemia, hypercalcemia, impaired glucose tolerance, and per day, and women and lightweight people limit intake erectile dysfunction ranking second to beta-blockers.

As many as two-thirds of patients with hyper- sion. The loop diuretic torsemide may be the preferable tension will not achieve optimal blood pressure levels with agent for hypertension because its long half-life allows diuretic monotherapy and, as seen in multiple clinical tri- once daily administration in most patients. Side effects als, most patients require 2 to 4 agents. Discussing this fact also include hypokalemia and hyperuricemia.

While tory, or co-morbidities, JNC 7 recommends thiazide-type all agents in this class preserve potassium at the distal diuretics as the initial agent.

Of course, the choice of renal tubule, the sodium channel blockers amiloride and initial and subsequent agents is based on the discre- triamterene and aldosterone blockers work via different tion of physicians.

Issues such as cost, formulary, and mechanisms. The former block sodium channels directly, complexity of regimen must be kept in mind. A simple whereas the latter bind to the aldosterone receptor in rule to maximize the likelihood that patients will adhere the distal tubule to prevent aldosterone activation of the to the treatment regimen is to try to use once-a-day distal sodium channel. Spironolactone and eplerenone formulations, generic drugs, and combination agents.

If also block aldosterone activity in the heart, kidney, and branded products are required, try to limit co-payments blood vessels, which may explain the improved outcomes by adhering to formularies. If regimens are too complex in post-MI patients, and patients with heart failure.

The investigators also concluded that the month for doing so. ARBs directly occupy angiotensin II subtype 1 receptors. ARBs can also cause angio- ter. Clinical trials in cardiovascular that of ACE inhibitors , hyperkalemia, and acute renal fail- and renal disease are forthcoming and should help clarify ure. Both classes are contraindicated during pregnancy. Multiple clinical trials have demonstrated the efficacy Beta-blockers of ACE inhibitors in hypertensive patients, and there In early versions of JNC, beta-blockers were considered are compelling indications for their use post MI, and in first-line therapy, but in JNC 7 beta-blockers were consid- patients with heart failure, diabetes, chronic kidney dis- ered either add-on therapy to thiazide-type diuretics, or ease, and stroke.

Other nonspecific agents; the betaspecific agents; and beta- trials have demonstrated similar findings. The older nonspecific agents e. Table 4 In the recently completed large-scale bisoprolol, became mainstays for hypertension.

These agents tend to produce better nificant difference in the primary endpoint was observed central aortic blood pressure control than other beta- among the treatments, and the strategies were considered blockers, which may explain why these agents, and par- equivalent by the investigators Since they versus