Hypertension - Guidelines | Medical Science Optional Notes for UPSC PDF Download

Hypertension-JNC 8 Guidelines

Hypertension - Guidelines

The AHA/ACC ASCVD (Atherosclerotic Cardiovascular Disease) 2013 Risk Calculator assesses the 10-year risk of heart disease or stroke. It considers parameters such as age, sex, race, history of smoking, diabetes, hypertension treatment, and values of total cholesterol, HDL, and systolic blood pressure (SBP) in its calculation.

Non-Pharmacological Interventions

Pharmacological Interventions

1. Specific Recommendations:

• For the non-black population (including those with diabetes), initial treatment should encompass a thiazide-type diuretic, calcium channel blocker (CCB), angiotensin-converting enzyme inhibitor (ACE-I), or angiotensin receptor blocker (ARB).
• In the general African American population (including those with diabetes), the preferred initial treatment is a thiazide-type diuretic or CCB.
• Among adults with chronic kidney disease, the recommended initial (or add-on) treatment involves an ACE inhibitor or ARB to enhance kidney outcomes.

2. Initiation of Treatment and Follow-up:

• Consider the number of antihypertensives.
  • For newly diagnosed hypertension with blood pressure (BP) below 150/90 mm Hg, initiate therapy with one primary antihypertensive.
  • For newly diagnosed hypertension with BP above 150/90 mm Hg, initiate therapy with two primary antihypertensives.
• Reassess within one month of initiating or modifying pharmacological therapy.
  • If the treatment goal is not achieved with one drug, consider increasing the dose of the initial drug or adding a second drug.
  • If the treatment goal cannot be reached with two drugs, add a third drug.
  • Evaluate for secondary causes of hypertension.
  • If blood pressure is controlled, reassess after 3-6 months and subsequently on an annual basis.