The just-published sixth report of the Joint National Committee on Pre
vention, Detection, Evaluation, and Treatment of High Blood Pressure (
JNC VI) is expected to be a widely used guidance for hypertension mana
gement. This article reviews the report's drug therapy recommendations
, highlighting changes from the JNC V report. Diuretics or beta blocke
rs are still indicated as first-line treatment for uncomplicated hyper
tension, but other specific agents are now recommended as initial ther
apy for patients with comorbidities that constitute ''compelling'' ind
ications. Other topics discussed include the report's new risk-stratif
ication guidance, considerations for individualizing drug therapy, and
recommendations on the use of long-acting formulations and combinatio
n therapy. The author, chair of the JNC VI section on treatment, suppl
ements his review with personal recommendations for hypertension drug
therapy.