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Submitted on November 5, 2003
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. * To whom correspondence should be addressed. E-mail: roccelle{at}nhlbi.nih.gov.
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 physicians judgment remains paramount.
Revised on November 6, 2003
Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
Aram V. Chobanian;
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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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A. V. Tess and G. W. Smetana Medical Evaluation of Patients Undergoing Electroconvulsive Therapy N. Engl. J. Med., April 2, 2009; 360(14): 1437 - 1444. [Full Text] [PDF] |
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M. Sereg, A. Szappanos, J. Toke, K. Karlinger, K. Feldman, E. Kaszper, I. Varga, E. Glaz, K. Racz, and M. Toth Atherosclerotic risk factors and complications in patients with non-functioning adrenal adenomas treated with or without adrenalectomy: a long-term follow-up study Eur. J. Endocrinol., April 1, 2009; 160(4): 647 - 655. [Abstract] [Full Text] [PDF] |
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B. E. de Galan, V. Perkovic, T. Ninomiya, A. Pillai, A. Patel, A. Cass, B. Neal, N. Poulter, S. Harrap, C.-E. Mogensen, et al. Lowering Blood Pressure Reduces Renal Events in Type 2 Diabetes J. Am. Soc. Nephrol., April 1, 2009; 20(4): 883 - 892. [Abstract] [Full Text] [PDF] |
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P. Muntner, M. Krousel-Wood, A. D. Hyre, E. Stanley, W. C. Cushman, J. A. Cutler, L. B. Piller, G. A. Goforth, and P. K. Whelton Antihypertensive Prescriptions for Newly Treated Patients Before and After the Main Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial Results and Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Guidelines Hypertension, April 1, 2009; 53(4): 617 - 623. [Abstract] [Full Text] [PDF] |
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R. D. Feldman and F. A. McAlister Postgame Wrap of the Ultimate Blood Pressure Megatrial: Did It Score an ALLHAT Trick or Was It "Three Strikes and You're Out?" Hypertension, April 1, 2009; 53(4): 595 - 597. [Full Text] [PDF] |
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P. C. Schulze Beneficial Effects of Moderate Exercise in Arterial Hypertension Hypertension, April 1, 2009; 53(4): 600 - 601. [Full Text] [PDF] |
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J. M. Tobis and A. Perlowski Atheroma volume by intravascular ultrasound as a surrogate for clinical end points. J. Am. Coll. Cardiol., March 31, 2009; 53(13): 1116 - 1118. [Full Text] [PDF] |
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CORONARY REVASCULARIZATION WRITING GROUP, M. R. Patel, G. J. Dehmer, J. W. Hirshfeld, P. K. Smith, and J. A. Spertus ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: A Report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology: Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography Circulation, March 10, 2009; 119(9): 1330 - 1352. [Full Text] [PDF] |
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