TREATMENT OF HYPERTENSION - INSIGHTS FROM THE JNC-VI REPORT

The sixth report of the Joint National Committee on Prevention, Detect ion, Evaluation, and Treatment of High Blood Pressure (JNC-VI) provide s updated guidelines for the treatment of hypertension. Antihypertensi ve drug therapy may be initiated either after a trial of lifestyle mod ifications or immediately after the diagnosis is made, depending on th e patient's other cardiovascular risk factors and the presence of clin ical cardiovascular disease. In general, therapy may begin with diuret ics or beta-adrenergic blockers in patients tinder age 65, unless a co ncomitant condition warrants another, more tailored choice. Low dosage s should be used initially, but if the blood pressure is not successfu lly reduced to 140/90 mm Hg or below, another drug should be added or should replace the initial choice. General principles of therapy inclu de the use of once-a-day formulations and combination drugs as well as cost considerations.