Reconciling Systolic Blood Pressure Intervention Trial With Eighth Joint National Commission

A Nuanced View of Optimal Hypertension Control in the Chronic Kidney Disease Population

Ekamol Tantisattamo; Anum Hamiduzzaman; Peter Sohn; Rebecca Ahdoot; Ramy M. Hanna


Curr Opin Nephrol Hypertens. 2022;31(1):57-62. 

In This Article

Eighth Joint National Commission

The long-awaited JNC-8 recommendations, presented in 2014, were less interventionalist in certain populations and more conservative in nature.[8] Normal SBP was defined as <120 mmHg, prehypertension was defined as SBP 120–139 mmHg systolic (diastolic blood pressure (DBP) < 80 mmHg), Stage I hypertension was defined as 139–159mmHg, DBP < 90, and stage II hypertension was defined as 160/100+ mmHg.[8] Keeping in mind the side effects mentioned prior and physiological concerns, older adult BP control was opined to be best at <150/90 mmHg if symptoms from hypotension were a concern.[21] The guidelines still opined that certain groups of patients at higher risk may benefit from more intensive BP regulation.[8] These would include patients with albuminuria/proteinuria that have their BP goal maintained at <130/80 mmHg.[22] These guidelines, however, did not seem to factor in the results of SPRINT sufficiently to many cardiac and neurological interventionalists who disagreed with the concerns of those representing geriatric and kidney patients.[23]