Hypertension. 2003;42:1206-1252
Published online before print December 1, 2003, doi: 10.1161/01.HYP.0000107251.49515.c2
Published online before print December 1, 2003, doi: 10.1161/01.HYP.0000107251.49515.c2
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(Hypertension. 2003;42:1206.)
© 2003 American Heart Association, Inc.
JNC 7: Complete Report |
Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
From Boston University School of Medicine (A.V.C.), Boston, Mass; Rush University Medical Center (G.L.B., H.R.B.), Chicago, Ill; Veterans Affairs Medical Center (W.C.C.), Memphis, Tenn; University of Michigan (L.A.G.), Ann Arbor, Mich; State University of New York at Buffalo School of Medicine (J.L.I. Jr.), Buffalo, NY; University of Mississippi Medical Center (D.W.J.), Jackson, Miss; University of Miami (B.J.M.), Miami, Fla; University of Alabama at Birmingham (S.O.), Birmingham, Ala; Case Western Reserve University (J.T.W. Jr.), Cleveland, Ohio; National Heart, Lung, and Blood Institute (E.J.R.), Bethesda, Md.
Correspondence to Edward J. Roccella, PhD, Coordinator, National High Blood Pressure Education Program, National Heart, Lung, and Blood Institute, National Institutes of Health, Building 31, Room 4A10, 31 Center Drive MSC 2480, Bethesda, MD 20892. E-mail roccelle{at}nhlbi.nih.gov
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.
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T. H. Marwick, M. D. Hordern, T. Miller, D. A. Chyun, A. G. Bertoni, R. S. Blumenthal, G. Philippides, A. Rocchini, and on behalf of the American Heart Association Exerci Exercise Training for Type 2 Diabetes Mellitus: Impact on Cardiovascular Risk: A Scientific Statement From the American Heart Association Circulation, June 30, 2009; 119(25): 3244 - 3262. [Full Text] [PDF]
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D. S. Lee, P. Gona, R. S. Vasan, M. G. Larson, E. J. Benjamin, T. J. Wang, J. V. Tu, and D. Levy Relation of Disease Pathogenesis and Risk Factors to Heart Failure With Preserved or Reduced Ejection Fraction: Insights From the Framingham Heart Study of the National Heart, Lung, and Blood Institute Circulation, June 23, 2009; 119(24): 3070 - 3077. [Abstract] [Full Text] [PDF]
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E. T.H. Yeh and C. L. Bickford Cardiovascular complications of cancer therapy: incidence, pathogenesis, diagnosis, and management. J. Am. Coll. Cardiol., June 16, 2009; 53(24): 2231 - 2247. [Abstract] [Full Text] [PDF]
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 G. T. O'Connor, B. Caffo, A. B. Newman, S. F. Quan, D. M. Rapoport, S. Redline, H. E. Resnick, J. Samet, and E. Shahar Prospective Study of Sleep-disordered Breathing and Hypertension: The Sleep Heart Health Study Am. J. Respir. Crit. Care Med., June 15, 2009; 179(12): 1159 - 1164. [Abstract] [Full Text] [PDF]
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 P. S Sever, A. H Gradman, and M. Azizi Managing cardiovascular and renal risk: the potential of direct renin inhibition Journal of Renin-Angiotensin-Aldosterone System, June 1, 2009; 10(2): 65 - 76. [Abstract] [PDF]
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S. S. Shord, L. R. Bressler, L. A. Tierney, S. Cuellar, and A. George Understanding and managing the possible adverse effects associated with bevacizumab Am. J. Health Syst. Pharm., June 1, 2009; 66(11): 999 - 1013. [Abstract] [Full Text] [PDF]
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 F. Elijovich and C. Laffer A role for single-pill triple therapy in hypertension Therapeutic Advances in Cardiovascular Disease, June 1, 2009; 3(3): 231 - 240. [Abstract] [PDF]
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M. B. Lodish, N. Sinaii, N. Patronas, D. L. Batista, M. Keil, J. Samuel, J. Moran, S. Verma, J. Popovic, and C. A. Stratakis Blood Pressure in Pediatric Patients with Cushing Syndrome J. Clin. Endocrinol. Metab., June 1, 2009; 94(6): 2002 - 2008. [Abstract] [Full Text] [PDF]
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 C. A. Faria, R. S. Moraes, D. C. Sobral-Filho, A. G. Rego, M. F.P. Baracho, E. S.T. Egito, and J. Brandao-Neto Autonomic modulation in patients with congenital generalized lipodystrophy (Berardinelli-Seip syndrome) Europace, June 1, 2009; 11(6): 763 - 769. [Abstract] [Full Text] [PDF]
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 A. Ceroni, L. J. Chaar, R. L. Bombein, and L. C. Michelini Chronic absence of baroreceptor inputs prevents training-induced cardiovascular adjustments in normotensive and spontaneously hypertensive rats Exp Physiol, June 1, 2009; 94(6): 630 - 640. [Abstract] [Full Text] [PDF]
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R. Mogelvang, P. Sogaard, S. A. Pedersen, N. T. Olsen, J. L. Marott, P. Schnohr, J. P. Goetze, and J. S. Jensen Cardiac Dysfunction Assessed by Echocardiographic Tissue Doppler Imaging Is an Independent Predictor of Mortality in the General Population Circulation, May 26, 2009; 119(20): 2679 - 2685. [Abstract] [Full Text] [PDF]
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T. G. Allison Improving Weight Loss in Cardiac Rehabilitation Circulation, May 26, 2009; 119(20): 2650 - 2652. [Full Text] [PDF]
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 P. A. Sarafidis and G. L. Bakris Does Evidence Support Renin-Angiotensin System Blockade for Slowing Nephropathy Progression in Elderly Persons? Ann Intern Med, May 19, 2009; 150(10): 731 - 733. [Full Text] [PDF]
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 L. B. Hoffman, J. Schmeidler, G. T. Lesser, M. S. Beeri, D. P. Purohit, H. T. Grossman, and V. Haroutunian Less Alzheimer disease neuropathology in medicated hypertensive than nonhypertensive persons Neurology, May 19, 2009; 72(20): 1720 - 1726. [Abstract] [Full Text] [PDF]
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E. S. Muxfeldt, C. R. L. Cardoso, and G. F. Salles Prognostic Value of Nocturnal Blood Pressure Reduction in Resistant Hypertension Arch Intern Med, May 11, 2009; 169(9): 874 - 880. [Abstract] [Full Text] [PDF]
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D. Terentes-Printzios, C. Vlachopoulos, C. Stefanadis, S. K. Dudeja, R. K. Dudeja, J. S. Williams, S. Brown, and P. R. Conlin Blood-Pressure Measurement N. Engl. J. Med., May 7, 2009; 360(19): 2034 - 2035. [Full Text] [PDF]
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 D. L. Howard, A. P. Carson, D. N. Holmes, and J. S. Kaufman Consistency of Care and Blood Pressure Control among Elderly African Americans and Whites with Hypertension J Am Board Fam Med, May 1, 2009; 22(3): 307 - 315. [Abstract] [Full Text] [PDF]
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P. T. Einhorn National Heart, Lung, and Blood Institute-Initiated Program "Interventions to Improve Hypertension Control Rates in African Americans": Background and Implementation Circ Cardiovasc Qual Outcomes, May 1, 2009; 2(3): 236 - 240. [Full Text] [PDF]
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G. Ogedegbe, J. N. Tobin, S. Fernandez, W. Gerin, M. Diaz-Gloster, A. Cassells, C. Khalida, T. Pickering, A. Schoenthaler, and J. Ravenell Counseling African Americans to Control Hypertension (CAATCH) Trial: A Multi-Level Intervention to Improve Blood Pressure Control in Hypertensive Blacks Circ Cardiovasc Qual Outcomes, May 1, 2009; 2(3): 249 - 256. [Abstract] [Full Text] [PDF]
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 S. W. Rhee, J. R. Stimers, W. Wang, and L. Pang Vascular Smooth Muscle-Specific Knockdown of the Noncardiac Form of the L-Type Calcium Channel by MicroRNA-Based Short Hairpin RNA as a Potential Antihypertensive Therapy J. Pharmacol. Exp. Ther., May 1, 2009; 329(2): 775 - 782. [Abstract] [Full Text] [PDF]
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H. Izzedine, S. Ederhy, F. Goldwasser, J. C. Soria, G. Milano, A. Cohen, D. Khayat, and J. P. Spano Management of hypertension in angiogenesis inhibitor-treated patients Ann. Onc., May 1, 2009; 20(5): 807 - 815. [Abstract] [Full Text] [PDF]
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S. J. Lewis, K. M. Fox, M. F. Bullano, S. Grandy, and for the SHIELD Study Group Knowledge of Heart Disease Risk Among SHIELD Respondents With Dyslipidemia Circ Cardiovasc Qual Outcomes, May 1, 2009; 2(3): 207 - 212. [Abstract] [Full Text] [PDF]
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 P. C. Lavallee, J. Labreuche, F. Gongora-Rivera, A. Jaramillo, D. Brenner, I. F Klein, P.-J. Touboul, E. Vicaut, P. Amarenco, and on behalf of the Lacunar-B.I.C.H.A.T. Investigator Placebo-Controlled Trial of High-Dose Atorvastatin in Patients With Severe Cerebral Small Vessel Disease Stroke, May 1, 2009; 40(5): 1721 - 1728. [Abstract] [Full Text] [PDF]
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S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, D. M. Mancini, K. Michl, et al. 2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in Collaboration With the International Society for Heart and Lung Transplantation J. Am. Coll. Cardiol., April 14, 2009; 53(15): e1 - e90. [Full Text] [PDF]
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2005 WRITING COMMITTEE MEMBERS, S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, D. M. Mancini, et al. 2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation Circulation, April 14, 2009; 119(14): e391 - e479. [Full Text] [PDF]
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