title: Eighth Joint National Committee (JNC-8) Guidelines and the Outpatient Management of Hypertension in the African-American Population.
abstract: BACKGROUND
  Hypertension is a common medical disease, occurring in about one third of young adults and almost two thirds of individuals over the age of 60. With the release of the Eighth Joint National Committee on Prevention, Detection, Evaluation, and Treatment (JNC-8) guidelines, there have been major changes in blood pressure management in the various subgroups.
  
  
  OBJECTIVE
  Optimal blood pressure management and markers of end-organ damage in African-American adult patients were compared between patients who were managed according to the JNC-8 hypertension management guidelines and those who were treated with other regimens.
  
  
  METHODS
  African-American patients aged 18 years or older with an established diagnosis of hypertension were included in the study who were followed up in our internal medicine clinic between January 1, 2013 and December 31, 2103; the data on their systolic and diastolic blood pressure readings, heart rate, body mass index (BMI), age, gender, comorbidities, and medications were recorded. Patients were divided into four groups based on the antihypertensive therapy as follows - Group 1: Diuretic only; Group 2: Calcium channel blocker (CCB) only; Group 3: Diuretic and CCB; Group 4: Other antihypertensive agent. Their blood pressure control, comorbidities, and associated target organ damage were analyzed.
  
  
  RESULTS
  In all 323 patients, blood pressures were optimally controlled. The majority of the patients (79.6%) were treated with either a diuretic, a CCB, or both. Intergroup comparison analysis showed no statistically significant difference in the mean systolic blood pressure, mean diastolic blood pressure, associated comorbidities, or frequency of target organ damage.
  
  
  CONCLUSIONS
  Although diuretics or CCBs are recommended as first-line agents in African-American patients, we found no significant difference in the optimal control of blood pressure and frequency of end-organ damage compared to management with other agents.
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Abel
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Krysta
authors.initials: K
authors.lastname: Contino
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Navjot
authors.initials: N
authors.lastname: Jain
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Navjot
authors.initials: N
authors.lastname: Grewal
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Grand
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Iris
authors.initials: I
authors.lastname: Hagans
authors.affiliation: Cooper Research Institute, Cooper Medical School of Rowan University, Camden, New Jersey, USA.
authors.forename: Krystal
authors.initials: K
authors.lastname: Hunter
authors.affiliation: Department of Medicine, Cooper University Hospital, Camden, New Jersey, USA.
authors.forename: Satyajeet
authors.initials: S
authors.lastname: Roy
keywords: African-American; Blood pressure; Cerebrovascular disease; Diabetes mellitus; Hypertension; Kidney disease; Myocardial infarction (MI); Thiazide; Thiazide diuretics; calcium channel blocker (CCB)