This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Hypertension  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: According to the JNC 7 recommendations,¹ treating patients to achieve a blood pressure of 135/85 mm Hg would be considered successful. However, pooled data suggest that this goal would double the risks of myocardial infarction, stroke, and cardiovascular disease compared with an even lower target of 115/75 mm Hg.^1-3

The lack of a prospective randomized trial to justify this lower target, as well as its financial implications to society, are 2 factors that may have led to the higher JNC 7 blood pressure goals. Because the principles of evidence-based medicine dictate that data from well-designed prospective investigations are valid sources to guide clinical practice,⁴ the results of prospective observational studies^2-3 should guide clinical decision making in this situation.

Given that many of the 100 million US adults with a blood pressure higher than 115/75 mm Hg might require a multidrug regimen to achieve this target, the costs . . . [Full Text of this Article]

Jonathan Sackner-Bernstein, MD
Heart Failure and Cardiomyopathy Center
North Shore University Hospital
Manhasset, NY

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

The JNC 7 Hypertension Guidelines
Hean Teik Ong
JAMA. 2003;290(10):1312.
EXTRACT | FULL TEXT  

The JNC 7 Hypertension Guidelines
Mark R. Nelson
JAMA. 2003;290(10):1312.
EXTRACT | FULL TEXT  

The JNC 7 Hypertension Guidelines
G. Divakara Murthy
JAMA. 2003;290(10):1313.
EXTRACT | FULL TEXT  

The JNC 7 Hypertension Guidelines
Opher Caspi
JAMA. 2003;290(10):1313.
EXTRACT | FULL TEXT  

The JNC 7 Hypertension Guidelines
Daniel J. Brotman and Shaun D. Frost
JAMA. 2003;290(10):1313-1314.
EXTRACT | FULL TEXT  

The JNC 7 Hypertension Guidelines
Barbara Phillips
JAMA. 2003;290(10):1314.
EXTRACT | FULL TEXT  

The JNC 7 Hypertension Guidelines
Thomas G. Majernick and Nancy Madden
JAMA. 2003;290(10):1314.
EXTRACT | FULL TEXT  

The JNC 7 Hypertension Guidelines—Reply
Aram V. Chobanian and Edward J. Roccella
JAMA. 2003;290(10):1314-1315.
EXTRACT | FULL TEXT  

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report
Aram V. Chobanian, George L. Bakris, Henry R. Black, William C. Cushman, Lee A. Green, Joseph L. Izzo, Jr, Daniel W. Jones, Barry J. Materson, Suzanne Oparil, Jackson T. Wright, Jr, and Edward J. Roccella
JAMA. 2003;289(19):2560-2571.
ABSTRACT | FULL TEXT  

Evidence-Based Medicine: A New Approach to Teaching the Practice of Medicine
Evidence-Based Medicine Working Group, Gordon Guyatt, John Cairns, David Churchill, Deborah Cook, Brian Haynes, Jack Hirsh, Jan Irvine, Mark Levine, Mitchell Levine, Jim Nishikawa, David Sackett, Patrick Brill-Edwards, Hertzel Gerstein, Jim Gibson, Roman Jaeschke, Anthony Kerigan, Alan Neville, Akbar Panju, Allan Detsky, Murray Enkin, Pamela Frid, Martha Gerrity, Andreas Laupacis, Valerie Lawrence, Joel Menard, Virginia Moyer, Cynthia Mulrow, Paul Links, Andrew Oxman, Jack Sinclair, and Peter Tugwell
JAMA. 1992;268(17):2420-2425.
PDF