The sixth report of the Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure

There has been a significant slowing in the previously remarkable decline in stroke and coronary heart disease deaths, whereas the incidence of heart failure and end-stage renal diseases continues to increase. Uncontrolled hypertension is a common denominator of these diseases. A reduction in hypertension awareness and knowledge of the need for treatment among the US population is thought to be partly to blame. The Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure (JNC) convened to address this problem, and the resultant report included guidelines that hopefully will help physicians better manage their hypertensive patients. The new recommendations place much greater emphasis on detecting overall cardiovascular risks and target organ diseases than the previous committee guidelines. For the first time, recommendations are made, including one that says combination treatment for hypertension may provide additional efficacy while it reduces the incidence of adverse effects. It should be noted that the full report is a concise document that provides guidelines for hundreds of hypertension-related patient scenarios. The highlights and major deviations from previous reports are presented in this Special Report.