Fwd: JNC-8 Guidelines for management of high blood pressure- published on 18th december

[rajeev kasliwal]

---------- Forwarded message ----------
From: Dr.Vyankatesh Shivane <drvks...@gmail.com>
Date: Thu, Dec 19, 2013 at 6:54 PM
Subject: Fwd: JNC-8 Guidelines for management of high blood pressure- published on 18th december
To: Nalini Shah <nalin...@gmail.com>, Tushar Bandgar <drtu...@gmail.com>, Anurag Lila <anura...@gmail.com>, rajeev kasliwal <rajeev....@gmail.com>, sweta budyal <sweta...@gmail.com>, Swati Jadhav <drswat...@hotmail.com>, Kranti Khadilkar <drkra...@gmail.com>, hiren patt <patt...@yahoo.com>, Shruti Khare <shruti...@yahoo.co.in>

FYI

---------- Forwarded message ----------
From: cardio update <cardiometab...@intaspharma.com>
Date: Thu, Dec 19, 2013 at 6:51 PM
Subject: JNC-8 Guidelines for management of high blood pressure- published on 18th december
To: cardio update <cardiometab...@intaspharma.com>

Dear Doctor,

 

Greetings from Intas Pharmaceuticals Ltd.

 

I am herewith sharing  treatment algorithm along with key recommendations from the recently published JNC-8 Guidelines for management of high blood pressure in adults.

 

JNC VIII full text- http://jama.jamanetwork.com/data/Journals/JAMA/0/jsc130010.pdf

 

JNC VIII Treatment algorithm

 

 

JNC 8 RECOMMENDATIONS  for management of high blood pressure in adults:-

 

1. In people over the age of 60, blood pressure target should be below 150/90 mmHg. Pharmacological therapy should be started if blood pressure is above this value.
2. If a patient achieves a blood pressure target lower than 150/90 and even lower than 140/90 mmHg, but tolerates this blood pressure and the medication without side-effects, no change is needed. In other words, there is no need to reduce medication dose to allow the blood pressure to go up.
3. In people under the age of 60, blood pressure target should be below 140/90 mmHg. Medical therapy should be started to achieve this target.
4. In adults (over the age of 18) who have chronic kidney disease the target blood pressure should be less than 140/90 mmHg. Treatment should include an ACE-inhibitor or angiotensin receptor blocker.
5. In adult diabetics, blood pressure should be lower than 140/90 mmHg and medication should be administered to achieve this. This recommendation is more lenient than in the previous version of the guidelines.
6. Choice of anti-hypertension medication is not very important in the non-black population. Options include thiazide diuretics, calcium channel blockers, ACE-inhibitors or angiotensin receptor blockers. ACE-inhibitors and ARB’s should not be used in conjunction in the same patient.
7. In black people, including those with diabetes, treatment of blood pressure should include a thiazide diuretic or a calcium channel blocker.
8. Treatment of blood pressure should escalate on a monthly basis. This can include either increasing drug dose or adding another drug from a different class (again – ACE-I and ARB’s should not be combined). Interestingly, lifestyle modifications are presented in JNC 8 as an adjunct to medical therapy, and not as a replacement (specifically in the algorithm on page E10).

9.  Starting a combination of two medications may be considered in patients in whom blood pressure upon presentation is greater than 160/100 mmHg or at least 20/10 mmHg above target blood pressure.

 

We hope that the provided information would be of your interest.

 

Please revert on this mail for further information.

Awaiting your valuable feedback & suggestions.

 

Thanks and regards, ?

 

Dr. Dixit Patel, MD

Medical Advisor,

Intas Pharmaceuticals Ltd.

Note : In case you are not interested to receive this scientific updates, please reply to this email stating “not interested”.

 

           

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Dr.Vyankatesh Shivane
Consultant Diabetologist & Metabolic Physician
Cell:9820084780
Fax:91 22 24153525

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Dr.Rajeev Kasliwal

M.D Medicine,D.M Endocrine 

K.E.M Hospital,Mumbai

Cell no.9221956703