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| Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure |
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| Author(s): Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ |
| Source: HYPERTENSION Volume: 42 Issue: 6 Pages: 1206-1252 Published: DEC 2003 |
| Times Cited: 2,294 References: 386 |
| 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. |
| Document Type: Review |
| Language: English |
| Reprint Address: Roccella, EJ (reprint author), NHLBI, Natl High Blood Pressure Educ Program, NIH, Bldg 31,Room 4A10,31 Ctr Dr MSC 2480, Bethesda, MD 20892 USA |
Addresses:
1. NHLBI, Natl High Blood Pressure Educ Program, NIH, Bethesda, MD 20892 USA
2. Boston Univ, Sch Med, Boston, MA 02118 USA
3. Rush Univ, Med Ctr, Chicago, IL 60612 USA
4. Vet Affairs Med Ctr, Memphis, TN USA
5. Univ Michigan, Ann Arbor, MI 48109 USA
6. SUNY Buffalo, Sch Med, Buffalo, NY 14260 USA
7. Univ Mississippi, Med Ctr, Jackson, MS 39216 USA
8. Univ Miami, Miami, FL 33152 USA
9. Univ Alabama, Birmingham, AL USA
10. Case Western Reserve Univ, Cleveland, OH 44106 USA |
| Publisher: LIPPINCOTT WILLIAMS & WILKINS, 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA |
| Subject Category: Peripheral Vascular Disease |
| IDS Number: 752TR |
| ISSN: 0194-911X |
| DOI: 10.1161/01.HYP.0000107251.49515.c2 |
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