Hypertension: Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure guidelines.

PURPOSE OF REVIEW: Hypertension has been recognized for decades as a major factor for stroke, with observational epidemiologic studies clearly identifying the increased stroke risks with blood pressure (BP) levels and randomized controlled clinical trials providing evidence of stroke risk reduction with lower BPs. Hypertension treatment and management guidelines, the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC) reports, have recognized the high impact of elevated BPs and influenced lower BPs with subsequent stroke risk reduction. In particular, the previous seven JNC reports included an evolution of SBP levels for treatment. This review addresses the influences of the JNC reports on stroke outcomes and describes the potential efforts of the upcoming guidelines. RECENT
FINDINGS: The recommendations of lower SBPs from the earlier reports were consistent with lower population BP shifts during the time period. The next JNC report will have a major focus on graded evidence from randomized clinical trials with detailed strategies and subsequent impact on stroke risks.
SUMMARY: The impact of the evidence-based guidelines will be expected to have enhanced effects on stroke rates by providing clinicians with current treatment and management recommendations.