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(Hypertension. 1996;28:711-712.)
© 1996 American Heart Association, Inc.

Articles

Staging of Hypertension and Potential Means for Estimating Disease Outcomes and Reimbursement

Marie A. Krousel-Wood, MD, MSPH; Edward D. Frohlich, MD

	Introduction

 
In this issue of Hypertension, we publish two articles concerned with the classification of hypertension according to disease severity. The first article, by Black and Yi, presents a new classification for hypertension based on relative and absolute risks with implications for treatment and reimbursement. In the second, Pogue et al evaluate the effect of the Fifth Joint National Committee's report on the assessment of the severity and treatment of hypertension.¹ The editors and referees of Hypertension feel that both are important articles that have the potential of providing a means for thinking about disease outcomes in hypertension as well as for providing a new way of assessing the implications of the severity of hypertension for reimbursement of providers for their management of hypertensive patients.

In this respect, some background information is necessary relating to the new classification of hypertension published in the Joint National Committee's Fifth Report in 1992 (JNC V)¹ as it deals with hypertension severity. This classification had several goals in mind. First, it underscored the fact that all patients with elevated arterial pressure (no matter how high the systolic or diastolic pressures) are at increased risk for premature cardiovascular morbidity and mortality. Second, it emphasized that point by stating that no form of essential hypertension is truly "mild" or, in fact, is without concern. Thus, Pogue et al took particular care to classify 1158 patients with essential hypertension according to the classifications suggested in both JNC IV and JNC V. With respect to the JNC V . . . [Full Text of this Article]