Beyond JNC 8: implications for evaluation and management of hypertension in underserved populations

Abstract

In the United States, hypertension is a significant medical problem that affects nearly 1 in 3 adults, causes thousands of deaths annually, and costs the nation billions of dollars annually for medical management in terms of hospitalisations, lost wages, and pharmacotherapy. The management guidelines of hypertension have greatly varied between different healthcare organisations including the American College of Cardiology (ACC), the European Society of Cardiology (ESC) and the Joint National Committee (JNC-7, 8). One of the points of contention is the generalisability of the guidelines to all individuals despite empirical evidence suggesting racial sensitivities to pharmacotherapy and high clinical adversities with elevations in blood pressure (BP). This manuscript will aim to review a brief history of the guidelines, the adjustment of the BP goals with pharmacotherapy for the management of hypertension, and discuss several socioeconomic factors attributing to higher clinical risks for certain minority racial groups susceptible to the new BPs goals for management under the JNC-8.

Keywords:

• Hypertension
• blood pressure
• atherosclerosis
• heart disease
• cardiology
• ACC
• JNC
• ESC

Acknowledgements

The authors would like to dedicate this piece to all of those affected by hypertension, and those working to become managers of their own health. In many cases, it is a preventable disease and we implore all to live a healthy and rich quality of life.

Disclosure statement

No potential conflict of interest was reported by the authors.