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January 25, 1993

Hypertension: Steps Forward and Steps BackwardThe Joint National Committee Fifth Report

Arch Intern Med. 1993;153(2):149-152. doi:10.1001/archinte.1993.00410020005001

HYPERTENSION CONTINUES to be one of the most common conditions treated by physicians. Ongoing research has better defined the mechanisms and clinical characteristics of this condition and enlarged the scope of therapeutic options. It is increasingly clear that high blood pressure, although an independent risk factor for adverse clinical events, frequently exists as part of a syndrome of cardiovascular, neuroendocrine, and metabolic abnormalities.1-3 Prognosis and appropriate treatment for the individual patient must, therefore, be based on considerations that go beyond blood pressure itself.

The Joint National Committee (JNC) on the Detection, Evaluation, and Treatment of High Blood Pressure has given opinions on the management of hypertension at 4-year intervals for almost 20 years. The recently published fifth report of the JNC (JNC V) concerning high blood pressure, presented as two separate and lengthy articles,4,5 offers detailed commentary on newer developments in the diagnosis and managementof hypertension, especially as

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