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Hypertension Guidelines 2014


Hypertension is a major risk factor for coronary artery disease (CAD) in 2014 new guidelines on the treatment of hypertension in people from the Eighth Joint National Committee (JNC 8). And  the American Society of Hypertension (ASH) Hypertension guidelines


Hypertension guidelines from the Eighth Joint National Committee JNC8:1

  • Nonblack, including those with diabetes :thiazide,CCB,ACEI, orARB
  • African American, including those with diabetes :thiazide or CCB
  • CKD: regimen should include an ACEI or ARB (including African Americans)
  • Can initiate with two agents ,especially if systolic>20mmHgabovegoalor diastolic>10 mmHg above goal.
  • If goal not reached:
    • Stress adherence to medication and lifestyle
    • Increase dose or add a second or third agent from one of the recommended classes.
    • Choose a drug outside of the classes recommended above only if these options have been exhausted .Consider specialist referral.


  American Society of Hypertension (ASH):2

  • Nonblack<60 years of age :First-line:ACEIor ARB

Second-line(add-on):CCB or  thiazide

Third-line :CCB plus ACEI or ARB plus thiazide

  • Nonblack 60 years of age and older:

First-line: CCB or thiazide preferred, ACEI, or ARB Second-line(add-on):CCB ,thiazide ,ACEI, or ARB (don’t use ACEI plus ARB)

Third-line:CCB plus ACEI or ARB plus thiazide

  • African American:

First-line :CCB or thiazide

Second-line(add-on):ACEI or ARB

Third-line :CCB plus ACEI or ARB plus thiazide



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