We have seen a few changes in hypertension guidelines as many adaptations and research has been conducted.
The ANCC and AANP are using the ACC/AHA guidelines for board certifications. So, we will discuss those guidelines to assist you with your studying.
Previously, JNC 8 guidelines focused on the person’s age, as well as their blood pressure reading. The latest guidelines do not focus on age, but the blood pressure reading and the patient’s past medical history.
These guidelines include the following:
- The focus is on two main BP goals. 130/80 & 140/90.
- People with comorbidities should maintain a blood pressure less than 130/80. If greater than 130/80, you will initiate treatment.
- People who are healthy without any comorbidities should maintain a blood pressure less than 140/90. If greater than 140/90, you will iniate treatment.
When I mention initiating treatment, you first want to instruct the patient on lifestyle modifications. This includes the DASH diet and exercising at least five days a week, for 30 minutes each day. The DASH diet focuses on limiting sodium intake.
After attempting lifestyle modifications, if the blood pressure remains above their goal blood pressure; you then will initiate medication therapy.
First line therapy are thiazides. ACE Inhibitors and ARBs are given to those who are diabetic or with chronic kidney disease, to protect their kidneys. Then, Calcium Channel Blockers are another BP medication utilized. It is best for ISH. CCBs also work well in combination with thiazides for African Americans.
Here is a quick video, covering HTN guidelines: Hypertension guidelines