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September 10, 2003

The JNC 7 Hypertension GuidelinesThe JNC 7 Hypertension Guidelines

JAMA. 2003;290(10):1312. doi:10.1001/jama.290.10.1312-a

To the Editor: We were disappointed to see the JNC 7 report's outdated admonition that "β-blockers should generally be avoided in individuals who have asthma [or] reactive airways disease."1 Most of the β-blockers used in today's clinical practice are cardioselective agents with minimal β2 effects. These newer agents confer little risk for bronchospasm. Because there is now ample evidence that β-blockers save lives in certain subsets of patients with hypertension—such as those with prior myocardial infarction, those undergoing major surgery, and those with congestive heart failure—it is crucial that these medications are not withheld based on outdated fears.