Cited by 25,386Blood Pressure and Hypertension StudiesSodium Intake and HealthClinical practice guidelines implementation

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure<SUBTITLE>The JNC 7 Report</SUBTITLE>

Chobanian, Aram V.·2003·JAMA

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, beta-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.

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Crossref · 10.1001/jama.289.19.2560

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Authors
Chobanian, A. V.
Affiliations
Boston University (US)
Corresponding author
Chobanian, Aram V.
Venue
JAMA
Published
2003-05-21
Volume
289
Issue
19
Pages
2560
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
OpenAlex
W2156121263
Cited by
25,386
References
59
Citations by year
2026: 169 · 2025: 261 · 2024: 358 · 2023: 377 · 2022: 499 · 2021: 608 · 2020: 697 · 2019: 731 · 2018: 808 · 2017: 866 · 2016: 976 · 2015: 1323 · 2014: 1629 · 2013: 1747 · 2012: 1747
FWCI
912.45
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords
hypertension, JNC 7 guidelines, blood pressure targets, systolic blood pressure, cardiovascular risk, prehypertension, thiazide diuretics, combination antihypertensive therapy, ACE inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers, patient motivation, physician-patient trust, lifestyle modification, diabetes mellitus, chronic kidney disease
MeSH terms
Adrenergic alpha-Agonists, Adrenergic alpha-Antagonists, Algorithms, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents, Blood Pressure, Blood Pressure Determination, Calcium Channel Blockers, Cardiovascular Diseases, Diagnostic Tests, Routine, Diuretics, Humans, Hypertension, Risk Factors, Vasodilator Agents, Blood Pressure Monitors, Risk Reduction Behavior, Angiotensin Receptor Antagonists

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