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 renal failure in the country. The Consortium for Southeastern Hypertension Control (COSEHC) is cooperating with other organizations in implementing initiatives to reduce morbidity and mortality from hypertension-related conditions in the southeastern United States. This article outlines for clinicians special consideration for implementation of the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) in the southeastern United States. Clinicians are encouraged to adapt the recommendations of JNC VI to their own patient groups, paying attention to these specific areas: (1) Ensure screening for hypertension in your practice and community. (2) Evaluate all patients for accompanying risk factors and target organ damage. (3) Promote lifestyle management 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 candidates for blood pressure goals of <130/85 mm Hg. (6) Pay attention to compelling and special indications such as diabetes, congestive heart failure, and renal dysfunction. (7) Consider combination therapy. (8) Maximize staff contributions to enhance patient adherence. (9) Encourage patient, family, and community activities to promote healthy lifestyles and blood pressure control.
Jones
D
D
University of Mississippi Medical Center, Jackson 39216-4505, USA. djones@medicine.umsmed.edu
Basile
J
J
Cushman
W
W
Egan
B
B
Ferrario
C
C
Hill
M
M
Lackland
D
D
Mensah
G
G
Moore
M
M
Ofili
E
E
Roccella
E J
EJ
Smith
R
R
Taylor
H
H
D001741:Black or African American / Q000706:statistics & numerical data; D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use; D016527:Drug Costs; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control / Q000628:therapy*; D007676:Kidney Failure, Chronic / Q000209:etiology; D008019:Life Style; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology; D009819:Office Visits; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D015995:Prevalence; D015144:Southeastern United States / Q000453:epidemiology; D020521:Stroke / Q000209:etiology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
D000959:Antihypertensive Agents