Thinking beyond new clinical guidelines: Update in hypertension

Hypertension is one of the most common conditions managed by generalists and is a major risk factor for multiple conditions. Surrounded by great debate, the committee appointed to the Eighth Joint National Committee published their suggestions for new hypertension treatment guidelines in early 2014. We suggest a new target blood pressure (BP) for the general population older than 60 years of less than 150/90 mm Hg, up from less than 140/90 mm Hg as recommended by the Seventh Joint National Committee, and in diabetic patients, a goal of less than 140/90 mm Hg, up from the Seventh Joint National Committee recommendation of less than 130/80 mm Hg. Regardless of the BP target recommendations suggested by the Eighth Joint National Committee and other organizations, obtaining accurate BP readings and recognizing white-coat and masked hypertension is imperative. Home and ambulatory BP monitoring are useful tools in addition to proper in-office BP readings. The optimal care of the hypertensive patient involves accurate BP characterization, careful use of guidelines, and good clinical judgment.