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Critics assail JNC 7 guidelines as misguided, misleading.
The JNC 7 hypertension guidelines promote a kind of "cookbook" medicine that, at best, will unnecessarily worry millions of healthy Americans and, at worst, may lead to inappropriate pharmacotherapy for truly hypertensive patients, according to two experts who argued their case in editorials in the American Journal of Hypertension.
"The idea of a blood pressure of 120/80 as prehypertensive is absolute garbage," Dr. Lawrence Resnick, the journal's editor, said in a press briefing at the meeting.
Dr. John Laragh, editor-in-chief of the journal, agreed. "By fiat, this has created 45 million more patients with a condition and no treatment," he said of the new "prehypertensive" category covering those with a systolic blood pressure of 120-139 mm Hg or a diastolic blood pressure of 80-89 mm Hg. "They're guessing that lifestyle modifications will be an effective treatment, but they won t. Lifestyle modifications (exercise, low-sodium diet, and weight loss) have never been proven as effective methods of blood pressure control because patients rarely succeed at implementing them.
The new guidelines should have focused more on effective blood pressure control for those who are really hypertensive, Dr. Laragh said. But that never happened, Dr. Laragh (Am. J. Hypertens. 16[5]:407-15, 2003) and Dr. Resnick (Am. J. Hypertens. 16[5]:421-25, 2003) argued in their editorials.
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