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National High Blood Pressure Education Program. The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Bethesda (MD): National Heart, Lung, and Blood Institute (US); 1997 Nov.

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Cover of The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure

The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.

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Foreword

The purpose of the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) is to provide guidance for primary care clinicians. The committee recognizes that the responsible clinician’s judgment of the individual patient’s needs remains paramount. Therefore, this national guideline should serve as a tool to be adapted and implemented in local and individual situations. Using evidence-based medicine and consensus, the report updates contemporary approaches to hypertension control. Among the issues covered are the important need for prevention of high blood pressure by improving lifestyles, the cost of health care, the use of self-measurement of blood pressure, the role of managed care in the treatment of high blood pressure, the introduction of new combination antihypertensive medications and angiotensin II receptor blockers, and strategies for improving adherence to treatment. The JNC VI report places more emphasis than earlier reports on absolute risk and benefit and uses risk stratification as part of the treatment strategy. This report strongly encourages lifestyle modification to prevent high blood pressure, as definitive therapy for some, and as adjunctive therapy for all persons with hypertension. On the basis of outcomes data from randomized controlled trials, this report recommends starting pharmacologic therapy with diuretics and beta-blockers for patients with uncomplicated hypertension and provides compelling indications for specific agents in certain clinical situations. This document also states that it is appropriate to choose other classes of antihypertensive agents in certain clinical situations and in patients with comorbid conditions. The National High Blood Pressure Education Program Coordinating Committee will release other advisories as the scientific evidence becomes available.

Dr. Sheldon Sheps is to be congratulated for leading the efforts to develop this document. He, along with the executive committee, worked diligently and brilliantly to assemble this report. This is evidence of how to use available science to develop practical guidelines for busy clinicians.

Claude Lenfant, M.D. Director National Heart, Lung, and Blood Institute

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