JNC 8 Hypertension Guideline Algorithm

Adult aged ≥ 18 years HTN

Implement Weight modification set
BP goal, initiate BP lowering
medication based on algoritm

Age ≥ 60 years Age < 60 years All Ages and Races

All Ages
CKD present with
Diabetes
or without
present No CKD
diabetes
BP Goal < BP Goal <
150/90 140/90

BP Goal < BP Goal <

140/90 140/90

Non Black Black

Initiate thiazide, ACEI, ARB, or Initiate thiazide or CCB, alone Initiate ACEI or ARB,
CCB, alone or in combo or in combo alone or combo
w/another class

At blood pressure goal?

No
Reinforce lifestyle and adherence Titrate medications doses oor
consider adding another medication (ACEI, ARB, CCB, Thiazide)

At blood pressure goal?

No
Reinforce lifestyle and adherence Add a medication class not already selected (i.e,
beta blocker, aldosterone antagonist, others) and titrate above medications to max
(see back of card)
Yes
At blood pressure goal? Continue tx and monitoring

Reinforce lifestyle and adherence Titrate needs to maximum doses,

add another med and/or refer to hypertension specialist

Gambar 2.3. Penatalaksana Hipertensi Menurut JNC 8

 Initial Drugs of Choice for Hypertension
- ACE Inhibitor (ACEI) Lifestyle drugs
- Angiotensin receptor blocker (ARB)
- Smoking Cessation
- Thiazide diuretic
- Control blood glucose and lipids
- Calcium channel blocker (CCB)
- Diet
o Eat healty (i.e, DASH diet)
o Moderate alcohol consumption
Strategy Description o Reduce sodium intake to no more
A Start one drug titrate to maximum than 2,400 mg/day
dose and then add second drug - Physical activity
B Start one drug then add a second o Moderate-tovigorous activity 3-4
drug before achieving max dose of days a week averaging 40 min per
first session
C Begin 2 drugs at same time, as
separate pills or combination pill.
Initial combination therapy is
recommended if BP is greater than
20/10 mmHg above goal

Gambar 2.3. Penatalaksana Hipertensi Menurut JNC 8