Guideline Comparisons of Goal BP and Initial Drug Therapy for Adults With Hypertension Guideline Population Goal BP, mm Hg Initial Drug Treatment Options guideline General 60 y <150/90 Nonblack: thiazide-type diuretic, ACEI, ARB, or CCB General <60 y <140/90 Black: thiazide-type diuretic or CCB Diabetes <140/90 Thiazide-type diuretic, ACEI, ARB, or CCB CKD <140/90 ACEI or ARB General nonelderly <140/90 -Blocker, diuretic, CCB, ACEI, or ARB General elderly <80 y <150/90 Diabetes <140/85 ACEI or ARB CKD no proteinuria <140/90 ACEI or ARB CKD + proteinuria <130/90 General <80 y <140/90 Thiazide, -blocker (age <60y), ACEI (nonblack), or ARB Diabetes <130/80 ACEI or ARB with additional CVD risk ACEI, ARB, thiazide, or DHPCCB without addi- tional CVD risk CKD <140/90 ACEI or ARB Diabetes <140/80 ACEI or ARB CKD no proteinuria 140/90 ACEI or ARB CKD + proteinuria 130/80 General <80 y <140/90 <55 y: ACEI or ARB General 80 y <150/90 55 y or black: CCB Black, lower risk <135/85 Diuretic or CCB Target organ damage or CVD risk Abbreviations: ADA, American Diabetes Association; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; CCB, calcium channel blocker; CHEP, Canadian Hypertension Education Program; CKD, chronic kidney disease; CVD, cardiovascular disease; DHPCCB, dihydropyridine calcium channel blocker; ESC, European Society of Cardiology; ESH, European Society of Hypertension; ISHIB, International Society for Hypertension in Blacks; JNC, Joint National Committee; KDIGO, Kidney Disease: Improving Global Outcome; NICE, National Institute for Health and Clinical Excellence. Clinical Review & Education Special Communication 2014 Guideline for Management of High Blood Pressure E12 JAMA Published online December 18, 2013 jama.com though the authors of this hypertension guideline did not conduct anevidencereviewoflifestyletreatmentsinpatientstakingandnot takingantihypertensivemedication,wesupporttherecommenda- tions of the 2013 Lifestyle Work Group.45 Therecommendationsfromthisevidence-basedguidelinefrom panel members appointed to the Eighth Joint National Committee (JNC 8) offer clinicians an analysis of what is known and not known about BP treatment thresholds, goals, and drug treatment strate- gies to achieve those goals based on evidence from RCTs. 