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GENERAL CONSIDERATIONS

The definition of “hypertension” remains controversial between multiple organizations with the publications of the 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults by the Eighth Joint National Committee (JNC-8) followed by the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) Clinical Practice Guideline for High Blood Pressure in Adults (Table 35–1). The American Academy of Family Physicians continues to support the JNC-8 recommendations after a thorough review and has chosen not to endorse the ACC/AHA guidelines. The ACC/AHA guidelines substantially increase the number of people diagnosed with hypertension, resulting in a small increase in the percentage of US adults recommended to begin antihypertensive medication as well as recommending more intensive therapy and blood pressure lowering for those already taking antihypertensive medications.

Table 35–1.Classification and management of blood pressure in adults.a

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