Question

The nurse prepares to discuss the changes in how the JNC 7 defines hypertension. What ranges and descriptions should the nurse include?

Answer 1

JNC 7 is the seventh report the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure. It simplifies the categorization pf blood pressure among adults and gives guidelines on how to prevent and manage hypertension according to the new classification system.

Blood Pressure classification according to JNC 7:

• Normal: systolic BP <120 and diastolic BP <80.
• Prehypertension: Systolic BP 120 -139 or Diastolic BP 80 - 89.
• Stage 1 hypertension: Systolic BP 140 - 159 or Diastolic BP 90 - 99.
• Stage 2 hypertension: Systolic BP > or equal to 160 or Diastolic BP > or equal to 100.

The main recommendations based on this classification are:

• Prehypertension requires life style modifications like low salt diet, regular exercises and all in order to prevent the occurrence of hypertension in the future. It is not a disease category which requires drug therapy. If they have any associated illness like diabetes, kidney disease etc, then drug therapy must be initiated accordingly.
• For patients with hypertension, the basic goal of BP is <140/90 mm of Hg, but it is < 130/80 mm of Hg for patients with diabetes or renal disease.
• As age advances, an increase in SBP poses more cardiovascular risk than an elevated DBP.
• Thiazide diuretics can be used in the initial treatment of uncomplicated hypertension as studies have shown that it reduces the risk of CAD, stroke etc. It can be used alone or in combination with other drugs.