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JNC 8 Guidelines#
JNC 8 (2014) recommends:
- General population <60: <140/90 mmHg
- Age 60+: <150/90 mmHg
- Diabetes: <140/90 mmHg
- CKD: <140/90 mmHg
ACC/AHA 2017 Guidelines#
ACC/AHA lowered the threshold for hypertension to 130/80 mmHg. New categories: Elevated (120-129/<80), Stage 1 (130-139/80-89), Stage 2 (>140/>90).
ESC/ESH 2018 Guidelines#
European guidelines use 140/90 for office BP and 130/80 for out-of-office measurements.
Drug Class Comparison#
| Class | Example | Indication | Contraindication |
|---|---|---|---|
| ACE-I | Enalapril | DM, CKD, HF | Pregnancy, bilateral RAS |
| ARB | Telmisartan | DM, CKD | Pregnancy |
| CCB | Amlodipine | Isolated systolic HTN | HF with reduced EF (diltiazem) |
| Thiazide | Chlorthalidone | General | Gout, hyponatremia |
Special Populations#
Pregnancy: Labetalol, nifedipine, methyldopa. Emergency: Hydralazine (1st line per WHO), labetalol IV.
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References & further reading
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Revision history
- 19 September 2026 — Initial publication
Frequently asked questions
What is the BP target for patients under 60 per JNC 8?
JNC 8 recommends <140/90 mmHg for adults under 60. For those 60+, <150/90 mmHg. These targets differ from ACC/AHA which recommends <130/80 for all adults.
Which antihypertensive is first-line in diabetes?
ACE inhibitors (or ARBs) are first-line in diabetic patients for renal protection. JNC 8 recommends thiazide-type diuretics, CCBs, ACE inhibitors, or ARBs in the general black population.
What is the drug of choice in pregnancy?
Labetalol, nifedipine (extended-release), or methyldopa. ACE inhibitors, ARBs, and direct renin inhibitors are contraindicated in pregnancy.
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