PERSPECTIVES ON THE NEW JNC-VI GUIDELINES FOR THE TREATMENT OF HYPERTENSION

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.