Hypertension (JNC-8) Mnemonic

The target blood pressure (BP) of healthy patients over age 60 is 150 mmHg systolic over 90 mmHg diastolic, more commonly written as 150/90.

The target blood pressure of healthy patients over age 60 is 150 mmHg systolic over 90 mmHg diastolic.

The target blood pressure of healthy patients under age 60, as well as all patients with diabetes mellitus or CKD, is 140/90.

Healthy patients under age 60, and all patients with diabetes mellitus or CKD, should have a target BP of 140/90.

A systolic BP of 140 mmHg systolic and a diastolic pressure of 90 mmHg are the optimal pressures for patients with diabetes mellitus or CKD.

For non-African American patients with hypertension, treatment should begin with a thiazide diuretic, an angiotensin converting enzyme (ACE) inhibitor, an angiotensin receptor blocker (ARB), or a calcium channel blocker (CCB). These drugs may be used alone or in combination to lower blood pressure; however, patients should not take ACE inhibitors and ARBs together to control hypertension.

In hypertensive patients age 18 and over with chronic kidney disease (with or without diabetes), clinical trials have shown ACE inhibitors or ARBs to be the most effective.

ACE inhibitors and ARBs have been shown to be the most effective pharmacological treatment of hypertension in patients with chronic kidney disease. However, patients should not take ACE inhibitors and ARBs together to control hypertension.

African Americans develop high blood pressure earlier in life than other groups in the U.S. This is thought to be due to genetic as well as environmental factors. African Americans are more likely to develop complications due to high blood pressure, which includes an increased incidence of stroke, cardiovascular disease, kidney disease, dementia, and blindness.

For African American patients with hypertension, treatment should begin with a thiazide diuretic, such as hydrochlorothiazide or a calcium channel blocker. These drugs have been shown to be more efficacious than ACE inhibitors and ARBS. In this group of patients, hypertension is more severe, the onset is earlier, and is associated with increased comorbidities.