Clinical Implications and Limitations of JNC7 in HTN Management and Recommendations for JNC8

Hypertension (HTN) is the persistent elevation of arterialblood pressure, and if untreated, it leads to coronary heartdisease (CHD) and target organ disease (TOD). 5 HTN is themost common primary diagnosis in the United States, affectingover 52 million Americans.6 The prevalence of HTN increaseswith age, is more common among African Americans, and ismore common among men. Since 2003, the current practiceguidelines for the evaluation and management of HTN in theUnited States have been made available by the National Heart,Lung, and Blood Institute. The Seventh Report of the JointNational Committee on Prevention, Detection, Evaluation, andTreatment of High Blood Pressure, or JNC 7, revised previousrecommendations. The practice guidelines were necessitatedby the findings of many observational studies and clinical trialsdealing with HTN; the need for useful, clear and concise clinicalguidelines; the JNC’s consensus that a simplified classificationof blood pressure (BP) was necessary; and a realization thatclinicians were not using previous guidelines very much.1–4