JNC 7 Express: The Seventh Report of the Joint National by National Institutes of Health

By National Institutes of Health

The 7th document of the Joint nationwide Committee at the Prevention, Detection, evaluate, and therapy of hypertension is the nationwide consensus assertion on high blood pressure. during this very sensible medical advisor, the committee spells out precisely what degrees blood strain require therapy and accordingly presents counsel to either way of life and drugs treatments.

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Extra info for JNC 7 Express: The Seventh Report of the Joint National Committe on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, 1st Edition

Example text

Abdominal obesity also is a component of metabolic syndrome. † Increased risk begins at approximately 55 and 65 years of age for men and women, respectively. Adult Treatment Panel III used earlier age cut points to suggest the need for earlier action. No clinical trials have prospectively evaluated the impact of reduced heart rate on cardiovascular outcomes. 20 The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Table 7. Identifiable causes of hypertension Chronic kidney disease Coarctation of the aorta Cushing’s syndrome and other glucocorticoid excess states including chronic steroid therapy Drug induced or drug related (see table 18) Obstructive uropathy Pheochromocytoma Primary aldosteronism and other mineralocorticoid excess states Renovascular hypertension Sleep apnea Thyroid or parathyroid disease Laboratory Tests and Other Diagnostic Procedures Routine laboratory tests recommended before initiating therapy include a 12-lead electrocardiogram; urinalysis; blood glucose and hematocrit; serum potassium, creatinine (or the corresponding estimated glomerular filtration rate [eGFR]), and calcium;66 and a lipoprotein profile (after a 9- to 12-hour fast) that includes high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides.

180/110 mmHg), evaluate and treat immediately or within 1 week depending on clinical situation and complications. , 160/86 mmHg should be evaluated or referred to source of care within 1 month). † Modify the scheduling of followup according to reliable information about past BP measurements, other cardiovascular risk factors, or target organ disease. ‡ Provide 18 advice about lifestyle modifications (see Lifestyle Modifications). 60 These devices use either a microphone to measure Korotkoff sounds or a cuff that senses arterial waves using oscillometric techniques.

At least two measurements should be made and the average recorded. For manual determinations, palpated radial pulse obliteration pressure should be used to estimate SBP—the cuff should then be inflated 20–30 mmHg above this level for the auscultatory determinations; the cuff deflation rate for auscultatory readings should be 2 mmHg per second. SBP is the point at which the first of two or more Korotkoff sounds is heard (onset of phase 1), and the disappearance of Korotkoff sound (onset of phase 5) is used to define DBP.

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