Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The Weapons Are Ready

High Blood Pressure (JNC 7) has recently came to light in a short version. A complete version will soon be available. JNC 7 is the last attempt to bridge the big gap between the current availability of potent and well tolerated antihy-pertensive strategies and their poor implementation in the clinical practice. Some new and important features cha-racterize the JNC 7 document. The aim of the new and challenging definition of «pre-hypertension » (BP 120-139/80-89 mmHg) is to sensitize the general population and health professionals to implement effective strategies for a healthier life in order to prevent hypertension and re-lated cardiovascular disease as early as possible. Stage 3 hypertension has been deleted and merged with stage 2 (systolic ≥ 160 or diastolic ≥ 100 mmHg). BP levels to achieve with treatment («goals») are < 140/90 mmHg (< 130/80 mmHg in diabetics). To reach the goal, diuretics are recommended for initial treatment «in most subjects with stage I hypertension». However, combination of at least 2 drugs is recommended if initial BP is 20/10 mmHg higher than goal BP. Apart from the definition of pre-hy-pertension and the advice to begin therapy with diuretics in most patients with stage 1 hypertension, JNC 7 shares several positions with the hypertension guidelines re-cently released by the European Society of Cardiology and European Society of Hypertension. JNC 7 seems to dedicate limited space to stratify the level of cardiovascu-lar risk in the individual subjects on the basis of the diffe-rent combinations between BP levels and concomitant risk factors. In summary, JNC 7 is an updated and well equipped arsenal of formidable weapons against hyper-tension and its complications. The stage is now set for an hard task: their effective implementation in the clinical practice with the aim to decrease cardiovascular morbidity and mortality