Compliance with Joint National Committee 7 guidelines in hypertension management in a teaching institution.
OBJECTIVE
To assess compliance with Joint National Committee 7 (JNC 7) guidelines and evaluate target blood pressure (BP) goals among patients with hypertension.


RESULTS
Basic laboratory workup was completed on 75% of patients, and 71% received smoking cessation counseling. Overall BP goal achievement was 45.6%; it was 27.6% and 21.1% among diabetes and chronic kidney disease (CKD) patients, respectively. An average of 2.6 antihypertensive medications were prescribed per patient, with beta-blockers being the most frequently used, followed by thiazide diuretics and angiotensin-converting enzyme inhibitors (ACEIS). ACEIS or angiotensin receptor blockers (ARBs) were not prescribed for 16% of diabetics, 26% of chronic renal failure patients, or 41% of those with history of stroke. Among heart failure patients, 24.1% were not on ACEI or ARBs, and 20.7% were not receiving beta-blockers.


CONCLUSIONS
Certain aspects of JNC 7 are not well incorporated into clinical practice, especially among patients with coexisting diabetes and/or CKD.
Department of Internal Medicine, West Virginia University, Charleston, USA.
Prasuna
P
Jami
Pamela
P
Smith
Shalini
S
Moningi
Venkata
V
Moningi
Shelda A
SA
Martin
Gregory
G
Rosencrance
Bernardo J
BJ
Reyes
D000428:Alcohol Drinking; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D015897:Comorbidity; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D016540:Smoking Cessation
D000959:Antihypertensive Agents