JNC8 (the Eigth Joint National Commission) released their recommendations for blood pressure management this week. The full article as published in JAMA can be found at http://jama.jamanetwork.com/article.aspx?articleid=1791497

Highlights from this report are

• Older adults do not need to be placed on antihypertensive medications unless their SBP > 150 or DBP > 90. 
• Younger patients should still be started if their SBP > 140 or DBP > 90.
• Firstline drug treatment recommendations are:
  • Non-black patients: start with thiazide diuretics, calcium channel blockers, angiotension converting enzyme (ACE) inhibitors, or angiotension-receptor blockers (ARBs).
  • For black patients start with thiazide diuretics or calcium channel blockers.
  • Patients with chronic kidney disease should be on an ACE or ARB.

General Pearl:  Remember to be cautious in acutely lowering the blood pressure in asymptomatic patients.  Acute lowerings can cause watershed ischemia leading to strokes.