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

International Society of Hypertension

The International Society of Hypertension (ISH) came up with a sweeping and comprehensive set of recommendations for hypertension historical inquiry, workup, diagnosis, and treatment in 2020.[28] The details of the office and ambulatory BP measurements are also discussed in detail in these guidelines; however, the most salient points of BP control include the simple grading system. Grade I hypertension is defined as BP < 140–159/90–99 mmHg[28] (similar to JNC-8 stage I hypertension),[8] and BP > 159/99 mmHg is defined as Grade II hypertension[28] (similar to JNC-8 stage II hypertension).[8] There is no 'prehypertension' defined in this scheme, though the guideline authors mention the need to incorporate CVD risk similar to the ACC/AHA[24] and ESH/ECC guidelines mentioned before.[27] The guidelines also similarly weave in the need for pharmacotherapy with lifestyle therapy and mention a novel issue, drug availability, likely important in making international recommendations for nations with a gamut of financial and social conditions affecting their delivery of healthcare.[28]