The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure

The JNC 7 Report

Aram V. Chobanian, George L. Bakris, Henry R. Black, William Cushman, Lee A. Green, Joseph L. Izzo, Daniel W. Jones, Barry J. Materson, Suzanne Oparil, Jackson T. Wright, Edward J. Roccella

Research output: Contribution to journalReview article

13556 Citations (Scopus)

Abstract

"The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure" provides a new guideline for hypertension prevention and management. The following are the key messages: (1) In persons older than 50 years, systolic blood pressure (BP) of more than 140 mm Hg is a much more important cardiovascular disease (CVD) risk factor than diastolic BP; (2) The risk of CVD, beginning at 115/75 mm Hg, doubles with each increment of 20/10 mm Hg; individuals who are normotensive at 55 years of age have a 90% lifetime risk for developing hypertension; (3) Individuals with a systolic BP of 120 to 139 mm Hg or a diastolic BP of 80 to 89 mm Hg should be considered as prehypertensive and require health-promoting lifestyle modifications to prevent CVD; (4) Thiazide-type diuretics should be used in drug treatment for most patients with uncomplicated hypertension, either alone or combined with drugs from other classes. Certain high-risk conditions are compelling indications for the initial use of other antihypertensive drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, β-blockers, calcium channel blockers); (5) Most patients with hypertension will require 2 or more antihypertensive medications to achieve goal BP (<140/90 mm Hg, or <130/80 mm Hg for patients with diabetes or chronic kidney disease); (6) If BP is more than 20/10 mm Hg above goal BP, consideration should be given to initiating therapy with 2 agents, 1 of which usually should be a thiazide-type diuretic; and (7) The most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated. Motivation improves when patients have positive experiences with and trust in the clinician. Empathy builds trust and is a potent motivator. Finally, in presenting these guidelines, the committee recognizes that the responsible physician's judgment remains paramount.

Original languageEnglish (US)
Pages (from-to)2560-2572
Number of pages13
JournalJournal of the American Medical Association
Volume289
Issue number19
DOIs
StatePublished - May 21 2003

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Blood Pressure
Hypertension
Therapeutics
Sodium Chloride Symporter Inhibitors
Cardiovascular Diseases
Antihypertensive Agents
Guidelines
Angiotensin Receptor Antagonists
Calcium Channel Blockers
Chronic Renal Insufficiency
Angiotensin-Converting Enzyme Inhibitors
Pharmaceutical Preparations
Life Style
Motivation
Physicians
Health

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure : The JNC 7 Report. / Chobanian, Aram V.; Bakris, George L.; Black, Henry R.; Cushman, William; Green, Lee A.; Izzo, Joseph L.; Jones, Daniel W.; Materson, Barry J.; Oparil, Suzanne; Wright, Jackson T.; Roccella, Edward J.

In: Journal of the American Medical Association, Vol. 289, No. 19, 21.05.2003, p. 2560-2572.

Research output: Contribution to journalReview article

Chobanian, AV, Bakris, GL, Black, HR, Cushman, W, Green, LA, Izzo, JL, Jones, DW, Materson, BJ, Oparil, S, Wright, JT & Roccella, EJ 2003, 'The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report', Journal of the American Medical Association, vol. 289, no. 19, pp. 2560-2572. https://doi.org/10.1001/jama.289.19.2560
Chobanian, Aram V. ; Bakris, George L. ; Black, Henry R. ; Cushman, William ; Green, Lee A. ; Izzo, Joseph L. ; Jones, Daniel W. ; Materson, Barry J. ; Oparil, Suzanne ; Wright, Jackson T. ; Roccella, Edward J. / The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure : The JNC 7 Report. In: Journal of the American Medical Association. 2003 ; Vol. 289, No. 19. pp. 2560-2572.
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