To the Editor: We are surprised that the JNC
7 report1 did not recommend evaluation of
patients' overall cardiovascular risk, as did the most recent National Cholesterol
Education Program guidelines.2
Similarly, the authors of the Prospective Studies Collaboration3 stated that "given the continuous relationship
observed between blood pressure and risk of death from vascular disease, the
absolute benefits of a lower blood pressure level are likely to be greatest
for those at greatest absolute risk of vascular disease, largely irrespective
of their blood pressure level (except insofar as it is one of the factors
that influences this risk)." Hence, more informed counseling can be given
to a patient when the physician knows not only the blood pressure but also
a measure of absolute cardiovascular risk.
Majernick TG, Madden N. The JNC 7 Hypertension GuidelinesThe JNC 7 Hypertension Guidelines. JAMA. 2003;290(10):1312. doi:10.1001/jama.290.10.1312-a
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