Managing hypertension in the southeastern United States: Applying the guidelines from the Sixth Report of the Joint National Committee on Prevention,Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI)

The southeastern United States has the highest occurrence of heart disease and stroke and among the highest rates of congestive heart failure and rena l failure in the country. The Consortium for Southeastern Hypertension Cont rol (COSEHC) is cooperating with other organizations in implementing initia tives to reduce morbidity and mortality from hypertension-related condition s in the southeastern United States. This article outlines for clinicians s pecial consideration for implementation of the Sixth Report of the Joint Na tional Committee on Prevention, Detection, Evaluation, and Treatment of Hig h Blood Pressure ONC VI in the southeastern United States. Clinicians are e ncouraged to adapt the recommendations of JNC VI to their own patient group s, paying attention to these specific areas: (1) Ensure screening for hyper tension in your practice and community. (2) Evaluate all patients for accom panying risk factors and target organ damage. (3) Promote lifestyle managem ent for individual patients and populations for prevention and treatment of hypertension. (4) Set a goal blood pressure for each patient, and monitor progress toward that goal. (5) Recognize that many patients will be candida tes for blood pressure goals of <130/85 mm Hg. (6) Pay attention to compell ing and special indications such as diabetes, congestive heart failure, and renal dysfunction. (7) Consider combination therapy. (8) Maximize staff co ntributions to enhance patient adherence. (9) Encourage patient, family, an d community activities to promote healthy lifestyles and blood pressure con trol.