The fifth Joint National Committee on Detection, Evaluation, and Treatment of
High Blood Pressure (JNC V) has recommended a new algorithm for treating
hypertension that emphasizes the use of drugs shown in randomized clinical trials to reduce cardiovascular morbidity and mortality--namely,
diuretics and beta blockers. The report contains several new sections, including new data from the National Health and Nutrition Examination Survey (NHANES III) on prevalence, awareness, treatment, and control of
hypertension, a new classification schema that includes systolic and diastolic criteria, and sections on the effects of
cocaine,
lithotripsy,
cyclosporine, and
erythropoietin to induce or aggravate
hypertension. Other topics have been greatly expanded, including special populations and situations, primary prevention of
hypertension, and life-style modifications. The JNC V report has also added
alpha-1 adrenergic blocking agents and the alpha-beta blocker
labetalol to the list of drugs suitable for initial monotherapy in managing
hypertension.