Chapter 11 Hypertension“compelling indications” for other agents. The JNC
7 recommendations are summarized in Fig. 11.7 and
Table 11.8.
Once antihypertensive drug therapy is initiated,
most patients should return for follow-up and
adjustment of medications at approximately 2–4
weekly intervals until the BP goal is reached. More
frequent visits will be necessary for patients with
JNC 7 Guidelines for the Management of Hypertension
Fig. 11.7 JNC Algorithm for the Management of Hypertension, 2003. “Compelling indications” were shown in Figure 12 of the original JNC
7 report; in this chapter they are shown as Table 11.8. The more recent AHA Scientifi c Statement on the Treatment of Hypertension in the
Prevention and Management of Ischemic Heart Disease differs from the JNC 7 guidelines in that recommended fi rst-line therapy for
uncomplicated hypertension should be an ACE inhibitor (or ARB), CCB or thiazide diuretic, or a combination of these. β-Blockers are
reserved for hypertensive patients with established coronary artery disease. Reprinted, with permission, from Chobanian et al. [1].
stage 2 hypertension or with complicating comorbid
conditions. Serum potassium and creatinine should
be monitored at least one to two times per year.
After BP is at goal and stable, follow-up visits can
usually be at 3- to 6-month intervals. Comorbidities,
such as HF, associated diseases, such as diabetes, and
the need for laboratory tests infl uence the frequency
of visits.