Joint National Committee (JNC) Guidelines For Hypertension

JOINT NATIONAL COMMITTEE (JNC) GUIDELINES FOR HYPERTENSION

Q. 1

Management of uncomplicated essential hypertension is:

 A

No need to treat

 B

Diet modification and exercise

 C

Diet modification, exercise & drugs

 D

Drugs alone

Q. 1

Management of uncomplicated essential hypertension is:

 A

No need to treat

 B

Diet modification and exercise

 C

Diet modification, exercise & drugs

 D

Drugs alone

Ans. C

Explanation:

Answer is C (Diet modification, exercise & drugs)

Management of uncomplicated essential hypertension includes health promoting lifestyle modifications (includes dietry modification & exercise) and pharmacological therapy (drugs).

Management of Uncomplicated Essential Hypertension

Lifestyle modification

Weight

reduction

Attain and maintain BMI <25 kg/m2

Dietary salt

reduction

<6 g NaCl/d

Adapt DASH-

Diet rich in fruits, vegetables, and low-fat

type dietary plan

dairy products with reduced content of

saturated and total fat

Moderation of

For those who drink alcohol, consume 2

alcohol

drinks/day in men and I drink/day in

consumption

women

Physical activity

Regular aerobic activity, e.g., brisk

walking for 30 min/d






 
 
 
 
 
 
 
 
 
 
 
Pharmacological Therapy
  • In uncomplicated essential hypertension the treatment is started with a low-dose thiazide (hydrochlorothiazide 12.5-25 mg per day), an ACE inhibitor or a beta-blocker.
  • Calcium-channel blocker can be used as the first-line treatment if the systolic pressure is high.
  • Angiotensin-II receptor antagonists should be considered when the adverse effects of ACE inhibitors or other drugs have proven problematic.
  • If no response is achieved, or adverse effects emerge, a
    product of another drug group should be prescribed.
  • Combination therapy is started if desired blood pressure reduction is not achieved with monotherapy.
  • The reasons behind poor response must be established.

Q. 2

A = ACE inhibitor, B = beta blocker, C = calcium channel blocker, D= diuretics. For elderly with hypertension antihypertensive drug of choice is ‑

 A

A or D

 B

A or B

 C

A or C

 D

C or D

Q. 2

A = ACE inhibitor, B = beta blocker, C = calcium channel blocker, D= diuretics. For elderly with hypertension antihypertensive drug of choice is ‑

 A

A or D

 B

A or B

 C

A or C

 D

C or D

Ans. D

Explanation:

Ans. is ‘d’ i.e., C or D

Pharmacological treatment of hypertension

Indications of drug therapy (the British hypertension society guidelines).

When sustained BP exceeds 160/100 mmHg or.

When BP is in the range of 140-159 / 90-99 mmHg and there is target organ damage or cardiovascular disease.

For diabetics when BP exceeds 140/90 mmHg.

The optimal target is to lower BP to or below 140/85 mmHg in nondiabetics and 140/80 mmHg in diabetics (WHO target is 130/85 mmHg).

Drug therapy

A simple stepped AB/CD regimen is used.

Quiz In Between



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