Which organizations have issued guidelines for target blood pressures?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

Target blood pressures have been provided in guidelines from the following organizations:

  • Joint National Committee (JNC)
  • European Society of Hypertension (ESH)/European Society of Cardiology (ESC)
  • American Heart Association/American College of Cardiology/American Society of Hypertension (AHA/ACC/ASH)
  • American Heart Association/American College of Cardiology (ACC)/Centers for Disease Control and Prevention (AHA/ACC/CDC)
  • American Society of Hypertension/International Society of Hypertension (ASH/ISH)
  • Department of Veterans Affairs (VA)/Department of Defense (DoD)
  • American Diabetes Association (ADA)
  • American College of Cardiology/American Heart Association (ACC/AHA)

A group was empaneled to write the Eighth Joint National Committee (JNC8) guideline, but this effort was discontinued by the National Heart, Lung, and Blood Institute (NHLBI). A paper was published in The Journal of the American Medical Association in 2014 that is generally referred to as 'JNC 8' but officially, there are no JNC 8 guidelines sanctioned by the NHLBI, nor has JNC 8 been endorsed by the AHA, ACC, or many other organizations that endorsed JNC7. 

A comparison of the target blood pressure recommendations for the guidelines issued by various organizations is provided in Table 5, below.

Table 5. Target Blood Pressure Recommendations (Open Table in a new window)

Issuing Organization

Year

Population

Target Blood Pressure

Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) [5]

2003

All adults except those with diabetes or chronic kidney disease

Adults with diabetes or chronic kidney disease

< 140/90 mm Hg

 

< 130/80 mm Hg

Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 8) [88]

2014

Adults age < 60 years and those >18 with diabetes or chronic kidney disease

 

Adults age ≥60 years

< 140/90 mm Hg

 

 

 

< 150/90 mm Hg

European Society of Hypertension/European Society of Cardiology (ESH/ECS) [126]

2013

All adults  except those with diabetes

 

 

 

Adults with diabetes

140-150 mm Hg systolic; consider < 140 mm Hg if the patient is fit and healthy; for ages ≥80 years, the patient's mental capacity and physical heath should also be considered if targeting to < 140 mm Hg

 

< 85 mm Hg diastolic BP

American Heart Association/American College of Cardiology/American Society of Hypertension (AHA/ACC/ASH) [130]

2015

Adults ages >80 years

 

 

Adults with CAD, except as noted below

 

Adults with MI, stroke, TIA, carotid artery disease, peripheral artery disease or abdominal aortic aneurysm

 

 

< 150/90 mm Hg

 

 

< 140/90 mm Hg

 

 

 

< 130/80 mm Hg

 

 

 

 

American Heart Association/American College of Cardiology (ACC)/Centers for Disease Control and Prevention (AHA/ACC/CDC) [131]

2014

All adults

< 140/90 mm Hg

American College of Cardiology/American Heart Association (ACC/AHA) [1]

2017

All adults

< 130/80 mm Hg

American Society of Hypertension/International Society of Hypertension (ASH/ISH) [132]

2014

Adults ages 18-79 years

 

Adults ages ≥80 years

< 140/90 mm Hg; < 130/80 mm Hg BP target may be considered in younger adults

< 150/90 mm Hg

Department of Veterans Affairs/Department of Defense (VA/DoD) [129]

2014

All adults

Adults with diabetes

< 150/90 mm Hg

< 150/85 mm Hg

American Diabetes Association (ADA) [71]

2016

Adults with diabetes

< 140/90 mm Hg; < 130/80 mm Hg target may be appropriate in younger adults

American Diabetes Association (ADA) [83]

2017

Adults with diabetes

< 140/90 mm Hg; < 130/80 mm Hg target may be appropriate for those at high risk of cardiovascular disease (if achievable without undue treatment burden)

CAD = coronary artery disease; MI = myocardial infarction; TIA = transient ischemic attack.


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