JNC 7 redefines diagnostic groups, endorses diuretics: controversial 'prehypertension' category includes about 45 million Americans. (Critics Question Focus of Guidelines).

Publication: Internal Medicine News

Publication Date: 15-JUN-03

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COPYRIGHT 2003 International Medical News Group

NEW YORK -- New guidelines issued by the National Heart, Lung, and Blood Institute cite an urgent need for early and aggressive intervention to prevent high blood pressure from causing serious health consequences.

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) redefines blood pressure categories and favors diuretic-based therapy. Unveiled at the annual meeting of the American Society of Hypertension, the guidelines are based on the results of more than 30 clinical trials conducted since the previous guidelines (JNC VI) were issued in 1997.

In a bold move that has sparked considerable debate, JNC 7 defines an entirely new class of "prehypertension" that applies to patients with a systolic blood pressure of 120-139 mm Hg or a diastolic blood pressure of 80-89 mm Hg. This includes about 45 million Americans, many of whom have previously been told that their blood pressure is normal.

Patients in this group merit attention--in the form of lifestyle-based intervention--because they face a significantly increased risk of developing hypertension and its complications, including kidney damage, cardiovascular disease, and stroke, said Dr. Aram Chobanian, dean of the Boston University School of Medicine and JNC 7 chairman. "To put it into perspective, for every 20/10 mm Hg rise in blood pressure above 115/75 mm Hg, there is a doubling in risk of death from...

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