Seventh Report of the Joint National Committee on ...

1 National High Blood Pressure Education ProgramPrevention,Detection,Evaluation, and Treatment of High Blood PressureThe Seventh Report of the Joint National Committee onComplete DEPARTMENT OF HEALTH AND HUMAN SERVICESN ational Institutes of Health National Heart, Lung, and Blood DEPARTMENT OF HEALTH AND HUMAN SERVICESN ational Institutes of HealthNational Heart, Lung, and Blood InstituteNational High Blood Pressure Education ProgramNIH Publication No. 04-5230 August 2004 Prevention,Detection,Evaluation, andTreatment of High Blood PressureThe Seventh Report of the Joint National Committee onComplete ReportThis work was supported entirely by theNational Heart, Lung, and Blood Executive Committee , writing teams,and reviewers served as volunteers Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood PressureChairAram V.

2 Chobanian, (Boston UniversitySchool of medicine , Boston, MA)Executive CommitteeGeorge L. Bakris, (Rush UniversityMedical Center, Chicago, IL); Henry R. Black, (Rush University Medical Center,Chicago, IL); William C. Cushman, (Veterans Affairs Medical Center, Memphis,TN); Lee A. Green, , (Universityof Michigan, Ann Arbor, MI); Joseph L. Izzo,Jr., (State University of New York atBuffalo School of medicine , Buffalo, NY);Daniel W. Jones, (University of MississippiMedical Center, Jackson, MS); Barry , , (University of Miami,Miami, FL); Suzanne Oparil, (Universityof Alabama at Birmingham, Birmingham, AL);Jackson T. Wright, Jr., , (CaseWestern Reserve University, Cleveland, OH)Executive SecretaryEdward J. Roccella, , (NationalHeart, Lung, and Blood Institute, Bethesda, MD)Financial DisclosuresDr.

3 Chobanian has received honoraria for servingas a speaker from Monarch, Wyeth, Astra-Zeneca, Solvay, and Bristol-Myers Bakris has received honoraria for serving as aspeaker from Astra-Zeneca, Abbott, Alteon,Biovail, Boerhinger-Ingelheim, Bristol-MyersSquibb, Forest, GlaxoSmithKline, Merck,Novartis, Sanofi, Sankyo, and Solvay; he hasreceived funding/grant support for research pro-jects from National Institutes of Health, Astra-Zeneca, Abbott, Alteon, Boerhinger-Ingelheim,Forest, GlaxoSmithKline, Merck, Novartis,Sankyo, and Solvay; he has served as a consul-tant/advisor for Astra-Zeneca, Abbott, Alteon,Biovail, Boerhinger-Ingelheim, Bristol-MyersSquibb, Forest, GlaxoSmithKline, Merck,Novartis, Sanofi, Sankyo, and Black has received honoraria for serving as aspeaker from Astra-Zeneca, Bristol-Myers Squibb,Novartis, Pfizer, Pharmacia, and Wyeth-Ayerst; hehas received funding/grant support for researchprojects from Bristol-Myers Squibb, Boehringer-Ingelheim, Merck, Pfizer, and Pharmacia; he hasserved as a consultant/advisor for Abbott, Astra-Zeneca, Biovail, Bristol-Myers Squibb,GlaxoSmithKline, Merck, Pfizer, and Pharmacia.

4 Dr. Carter has served as a consultant/advisor forBristol-Myers Cushman has received funding/grant supportfor research projects from Astra-Zeneca, Merck,Pfizer, Kos, Aventis Pharma, KingPharmaceuticals, GlaxoSmithKline, andBoehringer-Ingelheim; he has served as a consul-tant/advisor for Bristol-Myers Squibb, Sanofi,GlaxoSmithKline, Novartis, Pfizer, Solvay,Pharmacia, Takeda, Sankyo, Forest, and Biovail. Dr. Izzo has received honoraria for serving as aspeaker from Boehringer-Ingelheim, Merck, Pfizer,Astra-Zeneca, Solvay, Novartis, Forest, andSankyo; he has received funding/grant support forresearch projects from Boehringer-Ingelheim,Merck, Astra-Zeneca, Novartis, GlaxoSmithKline,and Biovail; he served as a consultant/advisor forMerck, Astra-Zeneca, Novartis, Intercure,Sankyo, and Nexcura.

5 He has stock holdings inIntercure, Jones has served as a consultant/advisor forPfizer, Bristol-Myers Squibb, Merck, Forest, Manger has served as a consultant/advisor forthe NHBPEP Coordinating Materson has served as a consultant/advisorfor Unimed, Merck, GlaxoSmithKline, Novartis,Reliant, Tanabe, Bristol-Myers Squibb, Pfizer,Pharmacia, Noven, Boehringer-Ingelheim, andSolvay. Dr. Oparil has received funding/grant support forresearch projects from Abbott Laboratories,Astra-Zeneca, Aventis, Boehringer-Ingelheim,Bristol-Myers Squibb, Eli Lilly, Forest,GlaxoSmithKline, Monarch, Novartis [Ciba],Merck, Pfizer, Sanofi/BioClin, Schering Plough,Schwarz Pharma, Scios Inc, GD Searle, Wyeth-Ayerst, Sankyo, Solvay, and Texas BiotechnologyCorporation; she has served as a consultant/advi-sor for Bristol-Myers Squibb, Merck, Pfizer,Sanofi, Novartis, The Salt Institute, and Wyeth-Ayerst; she is also on the Board of Directors forthe Texas Biotechnology Sowers has received honoraria for serving as aspeaker from Med Com Vascular BiologyWorking Group and Joslin Clinic Foundation.

6 Hehas received funding/grant support for researchprojects from Novartis and Wright has received honoraria for serving as aspeaker from Astra, Aventis, Bayer, Bristol-MyersSquibb, Forest, Merck, Norvartis, Pfizer, PhoenixPharmaceuticals, GlaxoSmithKline, andSolvay/Unimed; he has received funding/grantsupport for research projects from Astra, Aventis,Bayer, Biovail, Bristol-Myers Squibb, Forest,Merck, Norvartis, Pfizer, PhoenixPharmaceuticals, GlaxoSmithKline, High Blood Pressure Education ProgramCoordinating Committee Claude Lenfant, ( National Heart, Lung,and Blood Institute, Bethesda, MD); George , (Rush University Medical Center,Chicago, IL); Henry R. Black, (RushUniversity Medical Center, Chicago, IL);Vicki Burt, , ( National Center forHealth Statistics, Hyattsville, MD); Barry , , (University of Iowa,Iowa City, IA); Francis D.

7 Chesley, Jr., (Agency for Healthcare Research and Quality,Rockville, MD); Jerome D. Cohen, (SaintLouis University School of medicine , St. Louis,MO); Pamela J. Colman, (AmericanPodiatric Medical Association, Bethesda, MD);William C. Cushman, (Veterans AffairsMedical Center, Memphis, TN); Mark , , (Health Core, Inc.,Newark, DE); John J. Davis, (AmericanAcademy of Physician Assistants, Memphis,TN); Keith Copelin Ferdinand, , (Heartbeats Life Center, New Orleans, LA);Ray W. Gifford, Jr., , (ClevelandClinic Foundation, Fountain Hills, AZ);Michael Glick, (New Jersey DentalSchool, Newark, NJ); Lee A. Green, , (University of Michigan, Ann Arbor,MI); Stephen Havas, , , (University of Maryland School of medicine ,Baltimore, MD); Thomas H.

8 Hostetter, ( National Institutes of Diabetes and Digestiveand Kidney Diseases, Bethesda, MD); Joseph , Jr., (State University of New Yorkat Buffalo School of medicine , Buffalo, NY);Daniel W. Jones, (University of MississippiMedical Center, Jackson, MS); Lynn Kirby, , , (Sanofi-SynthelaboResearch, Malvern, PA); Kathryn M. Kolasa, , , (Brody School of Medicineat East Carolina University, Greenville, NC);Stuart Linas, (University of ColoradoHealth Sciences Center, Denver, CO); WilliamM. Manger, , (New York UniversityMedical Center, New York, NY); Edwin , , , (IndianaUniversity School of Optometry, Bloomington,IN); Barry J. Materson, , (University of Miami, Miami, FL); JayMerchant, (Centers for Medicare &Medicaid Services, Washington, DC); NancyHouston Miller, , (StanfordUniversity School of medicine , Palo Alto, CA);Marvin Moser, (Yale University School ofMedicine, Scarsdale, NY); William A.

9 Nickey, (Philadelphia College of OsteopathicMedicine, Philadelphia, PA); Suzanne Oparil, (University of Alabama at Birmingham,Birmingham, AL); Otelio S. Randall, , (Howard University Hospital,Washington, DC); James W. Reed, , , (Morehouse School ofMedicine, Atlanta, GA); Edward J. Roccella, , ( National Heart, Lung, andBlood Institute, Bethesda, MD); Lee Shaughnessy( National Stroke Association, Englewood, CO);Sheldon G. Sheps, (Mayo Clinic,Rochester, MN); David B. Snyder, , (Health Resources and Services Administration,Rockville, MD); James R. Sowers, , , (SUNY Health Science Centerat Brooklyn, Brooklyn, NY); Leonard , , (Eye Group, Oakhurst, NJ);Ronald Stout, , (Procter andGamble, Mason, OH); Rita D. Strickland, , (New York Institute of Technology,ivThe Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood PressurevThe Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood PressureSpringfield Gardens, NY); Carlos Vallbona, (Baylor College of medicine , Houston,TX); Howard S.

10 Weiss, , (Georgetown University Medical Center,Washington Hospital Center, Walter Reed ArmyMedical Center, Washington, DC); Jack , (Mayo Clinic and MayoMedical School, Rochester, MN); LaurieWillshire, , (American Red Cross,Falls Church, VA); Gerald J. Wilson, , (Citizens for Public Action on BloodPressure and Cholesterol, Inc., Potomac, MD);Mary Winston, , (American HeartAssociation, Dallas, TX); Jackson T. Wright, Jr., , (Case Western Reserve University,Cleveland, OH)Additional ContributorsJan N. Basile, , (VeteransAdministration Hospital, Charleston, SC);James I. Cleeman, ( National Heart,Lung, and Blood Institute, Bethesda, MD);Darla E. Danford, , (NationalHeart, Lung, and Blood Institute, Bethesda,MD); Richard A.