2014年美国成人高血压治疗指南JNC8.pdf

Clinical Review & Education
munication
2014 Evidence-Based Guideline for the Management
of High Blood Pressure in Adults
Report From the Panel Members Appointed
to the Eighth Joint mittee (JNC 8)
Paul A. James, MD; Suzanne Oparil, MD; Barry L. Carter, PharmD; William C. Cushman, MD;
Cheryl Dennison-Himmelfarb, RN, ANP, PhD; Joel Handler, MD; Daniel T. Lackland, DrPH;
Michael L. LeFevre, MD, MSPH; Thomas D. MacKenzie, MD, MSPH; Olugbenga Ogedegbe, MD, MPH, MS;
Sidney C. Smith Jr, MD; Laura P. Svetkey, MD, MHS; Sandra J. Taler, MD; Raymond R. Townsend, MD;
Jackson T. Wright Jr, MD, PhD; Andrew S. Narva, MD; Eduardo Ortiz, MD, MPH
Editorial pages 472, 474, and
Hypertension is the mon condition seen in primary care and leads to myocardial 477
infarction, stroke, renal failure, and death if not detected early and treated appropriately. Author Audio Interview at
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
Supplemental content at
evidence. This report takes a rigorous, evidence-based approach to mend 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 CME Quiz at
and
determining efficacy and effectiveness. Evidence quality and mendations were graded
CME Questions page 522
based on their effect on important es.
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 mends a BP of less than 140/90 mm Hg for those group