After years of waiting by clinicians, an update to the US guideline for the management of high blood pressure in adults was finally released in December. But it appears the cardiology community wants nothing to do with it. The elements underlying this reluctance appear to be turf battles and disagreement with a recommendation to ease the hypertension treatment threshold for individuals aged 60 years or older.
Released December 18 in JAMA, the guideline crafted by panel members appointed to the Eighth Joint National Committee (JNC 8) (http://tinyurl.com/qylsjdw) updates the previous guideline from the JNC 7, published in 2003 by the National Heart, Lung, and Blood Institute (NHLBI). But the NHLBI did not publish the JNC 8 update. The institute announced on June 19, 2013, that it was getting out of the guideline writing business to concentrate on developing systematic evidentiary reviews, which scientific associations could then use to create their own guidelines. The NHLBI’s decision left the JNC 8 panel members in limbo without a sponsoring agency, so they published independently in JAMA.
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Some cardiology groups are challenging a guideline that advises raising the hypertension treatment threshold from 140 mm Hg to 150 mm Hg systolic for individuals aged 60 years or older.
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