JNC-7 guidelines: are they still relevant?

The recommendations of the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), published in 2003, are largely relevant today. Lowering blood pressure (BP) to goal in hypertensive patients is of primary importance in reducing cardiovascular risk. Antihypertensive drugs vary in their efficacy to lower BP and can have BP-independent effects on cardiovascular events, as seen especially with regard to preventing heart failure and stroke. Thiazide-type diuretics were recommended as the preferred initial drugs for treatment of hypertension in most patients, and this is still an appropriate recommendation. Several other classes were recommended as next in priority, but beta-blockers should now have a lesser role in the management of uncomplicated hypertension. Although a new JNC report would be reassuring to practitioners and should include some changes since JNC 7, I consider most of the recommendations to still be relevant today.