New Hypertension therapy guidelines; JNC 8

A previous post here at The Living Word discussed the updated lipid therapy guidelines (from Circulation November 2013 as summarized in NEJM) and their new paradigm for treatment recommendations.  Also recently released (JAMA 2013 see link) were the new JNC 8 hypertension therapy guidelines.  The JNC 8 guidelines also provide new and practical goals for treatment.  Both studies (Lipids and JNC 8) were meta-analyses focusing on interpreting randomized controlled clinical trial data gathered over many years.  Both studies gave their recommendations formulated around the answering 3 important clinical questions.  The ACC/AHA lipid guidelines wanted to answer:  1 and 2.  What is the evidence that using cholesterol “cutoff” goals  facilitates treatment recommendations for the primary (1) and secondary (2) prevention of plaque?  Surprisingly, the answer is “None”.  3.  What is the impact on lipid levels, effectiveness and safety of statin treatment of plaque in patients?  Not surprisingly, the answer is “Alot”.  JNC 8 wanted to answer: 1.  Does starting treatment for hypertension at specific blood pressure thresholds effect outcomes?  2.  Does titrating bp treatment to goal effect outcomes?  3.  Do drug classes differ in comparative benefits?  The answer to all 3 is “Yes”.  See the link for the specifice recommendations and goals.





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