JNCVIII Guidelines

Question 1

In patients 60 years or older who do not have diabetes or chronic kidney disease,
the goal blood pressure level is now?

Answer 1

<150/90 mm Hg

Question 2

In patients 18 to 59 years of age without major comorbidities, and in patients 60
years or older who have diabetes, chronic kidney disease (CKD), or both conditions, the new goal blood pressure level is?

Answer 2

<140/90 mm Hg

Question 3

First-line and later-line treatments should now be limited to 4 classes of medications including:

Answer 3

thiazide-type diuretics, calcium channel blockers (CCBs), ACE inhibitors, and ARBs.

Question 4

When initiating therapy, patients of African descent without CKD should use?

Answer 4

CCBs and thiazides instead of ACE inhibitors.

Question 5

Use in all patients with CKD regardless of ethnic background, either as first-line therapy or in addition to first-line therapy would be?

Answer 5

ACE inhibitors and ARBs

Question 6

ACE inhibitors and ARBs should not be used in the same patient simultaneously–> True or False

Answer 6

T

Question 7

Patients over the age of 75 years with impaired kidney function due to the risk of hyperkalemia, increased creatinine, and further renal impairment should use?

Answer 7

CCBs and thiazide-type diuretics should be used instead of ACE inhibitors and ARBs

Question 8

In younger patients without major comorbidities, Which cardiovascular risk is a more important factor, elevated DBP or SBP?

Answer 8

DBP

Question 9

In patients 60 yrs or older, which pressure is more important, DBO or SBP?

Answer 9

SBP

Question 10

patients with chronic kidney disease receive medication sufficient to achieve what BP goal?

Answer 10

<140/90 mm Hg

Question 11

patients with chronic kidney disease or albuminuria 70 years or older should receive treatment based on?

Answer 11

Comorbidities, frailty, and other patient-specific factors

Question 12

Adults with diabetes and hypertension have reduced mortality as well as improved cardiovascular and cerebrovascular outcomes with treatment to a BP goal of?

Answer 12

SBP <150 mm Hg

Question 13

JNC 8 suggests patients with diabetes and hypertension opt for a goal of what BP even though it is not EBP?

Answer 13

<140/90 mm Hg

Question 14

Under JNC 8, in all cases, goal blood pressure targets should be reached within what time period?

Answer 14

A month of starting treatment either by increasing the dose of an initial drug or by using a combination of medications

Question 15

JNC 8 panel recommended what medication as initial therapy for most patients?

Answer 15

thiazide-type diuretics

Question 16

JNC 8 explains that the provider should take what measure before implementing later/line or 4th line antihypertensives to a patient?

Answer 16

Dosage Adjustment: Triple therapy with an ACE inhibitor/ARB, CCB, and thiazide-type diuretic would precede use of alpha-blockers, beta-blockers, or any of several other agents

Question 17

ACE inhibitors and ARBs may not be an ideal choice in patients of what ethnicity?

Answer 17

African Descent

Question 18

For patients over the age of 75 years with decreased renal function, what is the acceptable alternative to ACEs and ARBs?

Answer 18

thiazide-type diuretics or CCBs

Question 19

What lifestyle interventions are of importance in educating someone with HTN?

Answer 19

Dietary Approaches to Stop Hypertension (DASH) eating plan, weight loss, reduction in sodium intake to less than 2.4 grams per day, and at least 30 minutes of aerobic activity most days of the week.

Question 20

What are the guidelines pertaining to alcohol intake for those with HTN or potential HTN?

Answer 20

2 drinks daily in men and 1 drink daily in women. Note that 1 drink constitutes 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor. Quitting smoking also reduces cardiovascular risk