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May 1988

The 1988 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure

Author Affiliations

Boston University School of Medicine; Albert Einstein College of Medicine, Bronx, NY; University of Southern California (USC School of Medicine, Los Angeles, and Los Angeles County—USC Medical Center; Alton Ochsner Medical Foundation, New Orleans; Cleveland Clinic Foundation; University of Pennsylvania School of Nursing, Philadelphia; The University of Texas Southwestern Medical Center at Dallas; University of Mississippi Medical Center, Jackson; Bowman Gray School of Medicine, Winston-Salem, NC, and Danville Urologic Clinic, Danville, Va; Osteopathic Medical Center of Philadelphia; Brookdale Hospital Medical Center and State University of New York Health Science Center, Brooklyn; Columbia-Presbyterian Medical Center, New York; American Heart Association, Dallas; University of Alabama School of Medicine, Birmingham; Mayo Clinic, Rochester, Minn; Yale University School of Medicine, New Haven, Conn; National Heart, Lung, and Blood Institute, Bethesda, Md

From the National High Blood Pressure Education Program, Bethesda, Md.

Arch Intern Med. 1988;148(5):1023-1038. doi:10.1001/archinte.1988.00380050029006

• The National High Blood Pressure Education Program has released three Joint National Committee reports and a task force report on the detection, evaluation, and treatment of high blood pressure. Like its predecessors, the 1988 Joint National Committee report was developed using the consensus process; it is based on the latest scientific research and reflects the state of the art regarding hypertension management. This report updates findings of previous reports in several respects: it broadens the step-care approach to provide more flexibility for clinicians; encourages greater patient involvement in the treatment program; emphasizes a consideration of the quality of life in the management of patients; and addresses the cost of care. It also provides more emphasis on control of other risk factors for cardiovascular disease; includes a discussion of the new cholesterol guidelines; recommends a reduction in alcohol consumption; and discusses the use of calcium and fish oil supplementation. This document expands earlier reports on special populations, including blacks and other racial and ethnic minority groups, young and elderly patients, pregnant patients, surgical candidates, and hypertensive patients with cerebrovascular disease, coronary artery disease, left ventricular hypertrophy, congestive heart failure, peripheral vascular disease, renal disease, chronic obstructive pulmonary disease or bronchial asthma, gout, diabetes mellitus, and hyperlipidemia. The report also updates previous drug tables to include new drugs, revised recommended doses of some drugs, and drug interactions. Consideration of step-down therapy after blood pressure has been controlled is suggested. This report is intended as a guide for practicing physicians and other health professionals in their care of hypertensive patients and as a reference for those participating in the many community high blood pressure control programs throughout the country.

(Arch Intern Med 1988;148:1023-1038)

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