JNC8 (Guidelines for the Management of Hypertension in Adults) – The new guidelines answer three frequently asked questions: The guideline development group identified the three most important and highest profile questions in the management of hypertension through a modified Delphi method 1. When to start antihypertensive therapy? The group further clarified the blood pressure levels at which treatment needs to be initiated. The guidelines recommend that antihypertensive therapy should be initiated in older adults over 60 years of age when blood pressure reaches 150/90 mmHg; the target values for treatment are as described above. However, the group emphasized that the new guidelines do not redefine hypertension, and that the level of hypertension previously defined by the Joint National Committee7 (≥140/90 mm Hg) remains valid. People with blood pressure in this range should have lifestyle interventions. 2. What is the target value for blood pressure treatment? The answers to the three questions in the new guidelines are generally summarized as follows: the target value of hypertension treatment for elderly hypertensive patients aged 60 years or older should be 150/90 mm Hg; diastolic blood pressure for hypertensive patients aged 30-59 years should be less than 90 mm Hg. However, there is insufficient evidence to support the recommended target value of systolic blood pressure for hypertensive patients in this age group. There is also no evidence to support the target values for diastolic blood pressure in patients with hypertension under 30 years of age. In addition, for patients under 60 years of age with hypertension combined with diabetes mellitus or hypertension combined with non-diabetic chronic kidney disease (CKD), the guideline recommended therapeutic target values are consistent with those for the general hypertensive population under 60 years of age. 3. How to choose the starting medication for hypertension treatment? The guidelines recommend that for non-black hypertensive patients (including hypertensive patients with combined diabetes), the starting medications include ACEI drugs, ARB drugs, calcium channel blockers, and thiazide diuretics; for black hypertensive patients (including hypertensive patients with combined diabetes), the recommended starting medications are calcium channel blockers or thiazide diuretics. In addition, the guidelines recommend that for hypertensive patients with comorbid chronic kidney disease, ACERs or ARBs should be used to improve renal function at the start of treatment or when continuing anti-hypertensive therapy.