Perspectives on the new JNC VI guidelines for the treatment of hypertension

The just-published sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) is expected to be a widely used guidance for hypertension management. This article reviews the report's drug therapy recommendations, highlighting changes from the JNC V report. Diuretics or beta blockers are still indicated as first-line treatment for uncomplicated hypertension, but other specific agents are now recommended as initial therapy for patients with comorbidities that constitute 'compelling' indications. Other topics discussed include the report's new risk-stratification guidance, considerations for individualizing drug therapy, and recommendations on the use of long-acting formulations and combination therapy. The author, chair of the JNC VI section on treatment, supplements his review with personal recommendations for hypertension drug therapy.