Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
- PMID: 14656957
- DOI: 10.1161/01.HYP.0000107251.49515.c2
Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
Abstract
The National High Blood Pressure Education Program presents the complete Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Like its predecessors, the purpose is to provide an evidence-based approach to the prevention and management of hypertension. The key messages of this report are these: in those older than age 50, systolic blood pressure (BP) of greater than 140 mm Hg is a more important cardiovascular disease (CVD) risk factor than diastolic BP; beginning at 115/75 mm Hg, CVD risk doubles for each increment of 20/10 mm Hg; those who are normotensive at 55 years of age will have a 90% lifetime risk of developing hypertension; prehypertensive individuals (systolic BP 120-139 mm Hg or diastolic BP 80-89 mm Hg) require health-promoting lifestyle modifications to prevent the progressive rise in blood pressure and CVD; for uncomplicated hypertension, thiazide diuretic should be used in drug treatment for most, either alone or combined with drugs from other classes; this report delineates specific high-risk conditions that are compelling indications for the use of other antihypertensive drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, calcium channel blockers); two or more antihypertensive medications will be required to achieve goal BP (<140/90 mm Hg, or <130/80 mm Hg) for patients with diabetes and chronic kidney disease; for patients whose BP is more than 20 mm Hg above the systolic BP goal or more than 10 mm Hg above the diastolic BP goal, initiation of therapy using two agents, one of which usually will be a thiazide diuretic, should be considered; regardless of therapy or care, hypertension will be controlled only if patients are motivated to stay on their treatment plan. Positive experiences, trust in the clinician, and empathy improve patient motivation and satisfaction. This report serves as a guide, and the committee continues to recognize that the responsible physician's judgment remains paramount.
Comment in
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Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and evidence from new hypertension trials.Hypertension. 2004 Jan;43(1):1-3. doi: 10.1161/01.HYP.0000110061.06674.ca. Epub 2003 Dec 15. Hypertension. 2004. PMID: 14676222 No abstract available.
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Mortality from stroke and ischemic heart disease increases exponentially with blood pressure.Hypertension. 2004 Apr;43(4):e28;; author reply e28. doi: 10.1161/01.HYP.0000121366.89530.1c. Epub 2004 Feb 23. Hypertension. 2004. PMID: 14981060 No abstract available.
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Orthostatic hypotension in the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: which version is right?Hypertension. 2004 Apr;43(4):e27; author reply e27. doi: 10.1161/01.HYP.0000121365.95185.50. Epub 2004 Feb 23. Hypertension. 2004. PMID: 14981061 No abstract available.
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The JNC-7 guidelines and the optimal target for systolic blood pressure.Hypertension. 2004 May;43(5):e31; author reply e31. doi: 10.1161/01.HYP.000012525.15835.f1. Epub 2004 Mar 22. Hypertension. 2004. PMID: 15037559 No abstract available.
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