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May 1984

The 1984 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure

Author Affiliations

American Academy of Family Physicians, American Academy of Ophthalmology, American Academy of Physician Assistants, American Association of Occupational Health Nurses, American College of Cardiology, American College of Chest Physicians, American College of Physicians, American College of Preventive Medicine, American Dental Association, American Dietetic Association, American Heart Association, American Hospital Association, American Medical Association, American Nurses' Association Inc, American Occupational Medical Association, American Optometric Association, American Osteopathic Association, American Pharmaceutical Association, American Podiatry Association, American Public Health Association, American Red Cross, American Society of Hospital Pharmacists, Citizens for the Treatment of High Blood Pressure, Committee on Hypertension in Minority Populations, National Black Nurses' Association Inc, National Heart, Lung, and Blood Institute, National Kidney Foundation, National Medical Association, National Optometric Association, and the Society for Nutrition Education.; Chairman University of Alabama School of Medicine Birmingham; Boston University School of Medicine; Hahnemann University School of Medicine Philadelphia; University of Minnesota Medical School Minneapolis; Alton Ochsner Medical Foundation New Orleans; Cleveland Clinic Foundation; The Johns Hopkins University School of Nursing Baltimore; School of Public Health University of North Carolina Chapel Hill; Southwestern Medical School University of Texas Dallas; Kaiser Foundation Hospital Los Angeles; Highgate Medical Group Williamsville, NY; New York Medical College Valhalla, NY; Osteopathic Medical Center of Philadelphia and Metropolitan Hospital Philadelphia; Washington University and St Louis Veterans Administration Hospital St Louis; Harlem Hospital Center New York; National Heart, Lung, and Blood Institute National Institutes of Health Bethesda, Md; National Heart, Lung, and Blood Institute National Institutes of Health Bethesda, Md; Kappa-Systems Inc Washington, DC; Kappa-Systems Inc Washington, DC

From the National High Blood Pressure Education Program, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md. A complete listing of participants is given at the end of this article.

Arch Intern Med. 1984;144(5):1045-1057. doi:10.1001/archinte.1984.00350170211032

Since publication of the 1980 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure,1 several events have occurred that affect successful management of hypertension: publication of major clinical trial results, introduction of new antihypertensive agents, evidence concerning effectiveness of nonpharmacologic treatment, and further analysis of the epidemiologic data-base relating BPs with the risk of premature morbidity and mortality. These events led the director of the National Heart, Lung, and Blood Institute (NHLBI), as chairman of the National High Blood Pressure Education Program Coordinating Committee, to establish a new Joint National Committee to revise earlier recommendations.

This report includes recommendations on the following topics: (1) screening and referral procedures, (2) classification according to BPs, (3) use of nonpharmacologic therapies, (4) revised stepped-care approach, (5) management of mild hypertension, (6) patient-professional interaction, and (7) management of BP in special groups, including blacks, children, and pregnant

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