Killam MD on Hypertension Part 1
The Joint National Committee on the diagnosis and treatment of hypertension publishes guidelines every few years. I’m not smart enough to write these guidelines, but I am smart enough to know that I should read them! JNC 6 guidelines were published in 1997, JNC-7 guidelines were published in Dec. 2003 and JNC-8 guidelines were published in Feb. 2014. While similar, personally I found that the JNC-7 guidelines were simpler, made more sense, and were easier to understand and follow. It is about 80 pages long with a 1 page abstract with 8 points.
The first three points defined hypertension as >140/90, declared it as a risk factor for cardiovascular disease and stroke, and recommended lifestyle changes for pre-hypertension of 130-140/80-90. The fourth point states; “Thiazide-type diuretics should be used in the drug treatment of most patients with hypertension either alone or combined with drugs from other classes.” The fifth point states; “Most patients with hypertension will require two or more antihypertensive medications.” The sixth point states; “ If blood pressure is > 20/10 above goal, consideration should be given to initiating therapy with two agents, one of which usually should be a thiazide diuretic.” The seventh and eighth points mostly say that the patient is more likely to be compliant, and the treatment is more likely to be successful when the patient has confidence in his or her physician. The understanding and explanation of the treatment regimen are vital to its success.
If you are being treated for hypertension and are not on a Thiazide diuretic, then in my opinion, you should ask your physician “why not?” Let me explain why in my next blog.