Differences Between JNC8 2014 and AHA/ACC 2017-2018 Hypertension Guidelines
JNC8 2014 AHA/ACC 2017-2018
Methods Systematic review of RCTs
Conducted between 1996
and 2013 with subsequent
review of RCT evidence and
recommendations
Hypertension definitions Normal: <120/<80
Pre-hypertension: 120-
139/80-89
Stage 1: 140-159/90-99
Stage 2: >160/>100
Treatment initiation >60 yo: >150/90
thresholds
<60 yo or comorbid
conditions (DM, CKD):
>140/90
Treatment goals <140/90 if <60 yo or
comorbid conditions (DM,
CKD); (Grade E
recommendation)
<150/90 if >60 yo (Grade A
recommendation)
Medication selection Thiazide, ACEi/ARB, or CCB
Disproportionate weight to
the SPRINT trial, an RCT
assessing standard vs strict
blood pressure treatment
goals
Normal: <120/80
Elevated: SBP 120-129
Stage 1: 130-139/80-89
Stage 2: >140/>90
>130 SBP or >80 DBP if
history of CVD or >10%
ASCVD risk
>140/90 if no clinical CVD
and <10% ASCVD risk
<130/80