Important Clinical Updates

Updates will be listed on this page.

Important Updates:

Update as of January 2014:

Update to Hypertension Volume 4 of Edition 8 Chapter 1

After the completion of our Chapter on Hypertension by Stephen Huot, the panel members appointed to the Joint National Committee released updated Hypertension Guidelines were published in JAMA on December 18, 2013 (JNC8). Major changes to note: The new goal for blood pressure control for persons 60 years of age and older who do not have diabetes or chronic kidney disease is under 150/90. For persons 18-59 who have no comorbidities or any adults with diabetes or chronic kidney disease, the goal blood pressure goal is under 140/90. First line agents should now include one of the following choices: thiazides, calcium channel blockers, ACE inhibitors or ARBs. Patients of African-American descent should be initiated on thiazides or calcium channel blockers instead of ACE inhibitors. All patients with chronic kidney disease, regardless of ethnic or racial background, should be started on ACE inhibitors or ARBs. Paul A. James, et al 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) JAMA. Published online December 18, 2013. Three editorials accompanied this article as well. doi:10.1001/jama.2013.284427. Several excellent summaries are also available. Allan S. Brett, MD JNC 8 Has Finally Arrived. NEJM Journal Watch. December 24, 2013 reviewing James PA et al. JAMA . Weber MA et al. J Clin Hypertens (Greenwich) 2013 Dec 17. Krumholz, Harlan M. 3 Things to Know About the New Blood Pressure Guidelines. New York Times. December 18, 2013.