The Prevalence of Prehypertension and Hypertension Among US Adults According to the New Joint National Committee Guidelines

Abstract

On May 14, 2003, the National High Blood Pressure Education Program Coordinating Committee of the National Heart, Lung, and Blood Institute released the Seventh Report of the Joint National Committee (JNC) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (the JNC 7 report).¹ The new report was developed because, since the last report (JNC 6, released in 1997),² important new evidence has emerged from observational and clinical trials of hypertension management. The JNC 7 report synthesizes this evidence, and it also specifically simplifies the classification of blood pressure (BP) levels to maximize guideline implementation. According to the new report, normal BP is defined as systolic BP (SBP) less than 120 mm Hg and diastolic BP (DBP) less than 80 mm Hg; a SBP of 120 to 139 mm Hg or a DBP of 80 to 89 mm Hg is defined as prehypertension. The low-end threshold for prehypertension is lower than the previous designation of high-normal BP (ie, SBP/DBP: 130/85, JNC 6) (Table 1). Hypertension is still classified using cutoff points of SBP of 140 mm Hg or higher or DBP of 90 mm Hg or higher. The report emphasizes that even slightly elevated BP increases cardiovascular risk. Beginning at a SBP/DBP of 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The committee recommends lifestyle modifications for all patients with prehypertension and the addition of drug therapy for prehypertensive patients who have other compelling indicators, including multiple diseases.¹