2014 Hypertension Guideline – treatment goal should be reached in one month. If not reached, titration or the addition of another medication is recommended. Strategies to dose antihypertensive medications are provided for reference in the guidelines. Appendix 1: Comparison of 2014 Hypertension Guideline and Recommendations with JNC 7 Topic JNC 7 2014 Hypertension Guideline Methodology Nonsystematic literature review by Critical questions and review criteria expert committee including a range of defined by expert panel with input study designs from methodology team Recommendations based on consensus Initial systematic review by methodologists restricted to RCT evidence Subsequent review of RCT evidence and recommendation by the panel according to a standardized protocol Definitions Defined hypertension and Definitions of hypertension and prehypertension prehypertension not addressed, but thresholds for pharmacologic treatment were defined Treatment Goals Separate treatment goals defined for Similar treatment goals defined for all “uncomplicated” hypertension and for hypertensive populations except when subsets with various comorbid conditions evidence review supports different (diabetes and CKD) goals for a particular subpopulation Lifestyle Recommended lifestyle modifications Lifestyle modifications recommended Recommendations based on literature review and expert by endorsing the evidenced-based opinion Recommendations of the Lifestyle Work Group Drug Therapy Recommended 5 classes to be considered Recommended selection among 4 as initial therapy but recommended specific medication classes (ACEI or thiazide-type diuretics as initial therapy ARB, CCB, diuretics) and doses based for most patients without compelling on RCT evidence indications (i.e., diabetes, CKD, heart Recommended specific medication failure, myocardial infarction, stroke, and classes based on evidence review for high CVD risk racial, CKD, and diabetic subgroups Included a comprehensive table of oral Panel created a table of drugs and antihypertensive drugs including names doses used in the outcome trials and usual dose range Scope of topics Addressed multiple issues (blood Evidence review of RCTs addressed a pressure measurement methods, patient limited number of questions, those evaluation components, secondary judged by the panel to be of highest hypertension, adherence to regimens, priority resistant hypertension, and hypertension in special populations) based on literature review and expert opinion Review process Reviewed by the National High Blood Review by experts including those prior to Pressure Education Program Coordinating affiliated with professional and public publication Committee, a coalition of 39 major organizations and federal agencies; no
2014 Hypertension Guideline – treatment goal should be reached in one month. If not reached, titration or the addition of another medication is recommended. Strategies to dose antihypertensive medications are provided for reference in the guidelines. Appendix 1: Comparison of 2014 Hypertension Guideline and Recommendations with JNC 7 Topic JNC 7 2014 Hypertension Guideline Methodology Nonsystematic literature review by expert committee including a range of study designs Recommendations based on consensus Critical questions and review criteria defined by expert panel with input from methodology team Initial systematic review by methodologists restricted to RCT evidence Subsequent review of RCT evidence and recommendation by the panel according to a standardized protocol Definitions Defined hypertension and prehypertension Definitions of hypertension and prehypertension not addressed, but thresholds for pharmacologic treatment were defined Treatment Goals Separate treatment goals defined for “uncomplicated” hypertension and for subsets with various comorbid conditions (diabetes and CKD) Similar treatment goals defined for all hypertensive populations except when evidence review supports different goals for a particular subpopulation Lifestyle Recommendations Recommended lifestyle modifications based on literature review and expert opinion Lifestyle modifications recommended by endorsing the evidenced-based Recommendations of the Lifestyle Work Group Drug Therapy Recommended 5 classes to be considered as initial therapy but recommended thiazide-type diuretics as initial therapy for most patients without compelling indications (i.e., diabetes, CKD, heart failure, myocardial infarction, stroke, and high CVD risk Included a comprehensive table of oral antihypertensive drugs including names and usual dose range Recommended selection among 4 specific medication classes (ACEI or ARB, CCB, diuretics) and doses based on RCT evidence Recommended specific medication classes based on evidence review for racial, CKD, and diabetic subgroups Panel created a table of drugs and doses used in the outcome trials Scope of topics Addressed multiple issues (blood pressure measurement methods, patient evaluation components, secondary hypertension, adherence to regimens, resistant hypertension, and hypertension in special populations) based on literature review and expert opinion Evidence review of RCTs addressed a limited number of questions, those judged by the panel to be of highest priority Review process prior to publication Reviewed by the National High Blood Pressure Education Program Coordinating Committee, a coalition of 39 major Review by experts including those affiliated with professional and public organizations and federal agencies; no