Table 2.

Recommendations for the AHA/ACC Committee

General Area	JNC 8 Recommendation	Recommendations for AHA/ACC Committee
Diagnosis of hypertension	None	Add specific recommendations on use of ambulatory blood pressure monitoring and home blood pressure monitoring Devise a risk‐based strategy for determination of treatment initiation thresholds and targets Specify timeframe of attempting lifestyle modification alone before initiation of therapy
Treatment initiation thresholds and targets	Adults ≥60 y old, SBP/DBP treatment initiation threshold and target of 150/90 mm Hg	Lower the SBP treatment initiation threshold and target to 140 mm Hg for adults ≤80 y old16, 20, 21
	Adults >18 y old and <60 y old or any adult with diabetes or CKD, SBP/DBP treatment initiation threshold and target of 140/90 mm Hg	Lower DBP treatment initiation threshold and target to 85 mm Hg for diabetic adults,27, 31 Optional SBP/DBP treatment initiation threshold and target of ≤130/80 mm Hg for adults with CKD and >300 mg/d proteinuria35, 36 Add specific guidance for adults with preexisting CVD
Selection of therapy	Nonblack adults, including diabetics: first‐line therapy includes thiazides, CCB, ACEI/ARB Black adults, including diabetics: first‐line therapy includes thiazides or CCB Adults with CKD: first‐line therapy includes ACEI/ARB	For nonblack adults with preexisting CVD or diabetes, recommend ACEI or ARB as first‐line therapy For black adults with diabetes, recommend ACEI or ARB as add‐on therapy for patients requiring multidrug therapy

AHA indicates American Heart Association; ACC, American College of Cardiology; JNC, Joint National Committee; SBP, systolic blood pressure; DBP, diastolic blood pressure; CKD, chronic kidney disease; CVD, cardiovascular disease; CCB, calcium channel blocker; ACEI, angiotensin‐converting enzyme inhibitor; ARB, angiotensin type II receptor blocker.