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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 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.