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National High Blood Pressure Education Program

JNC 7 Express

The Seventh Report of the Joint National Committee on

Prevention, Detection, Evaluation, and Treatment of High Blood Pressure

U . S . D E P A R T M E N T O F H E A LT H A N D H U M A N S E R V I C E S National Institutes of Health National Heart, Lung, and Blood Institute

JNC 7 Express

The Seventh Report of the JointNational Committee on

Prevention, Detection, Evaluation, and Treatment of High Blood Pressure

This work was supported entirely by the National Heart, Lung, and Blood Institute. The Executive Committee, writing teams, and reviewers served as volunteers without remuneration.

U . S . D E PA RT M E N T O F H E A LT H A N D H U M A N S E RV I C E S National Institutes of Health NationalHeart, Lung, and Blood Institute National High Blood Pressure Education Program NIH Publication No. 03-5233 December 2003

Chair Aram V. Chobanian, M.D. (Boston University Medical Center, Boston, MA) Executive Committee George L. Bakris, M.D. (Rush Presbyterian-St. Luke’s Medical Center, Chicago, IL); Henry R. Black, M.D. (Rush Presbyterian-St. Luke’s Medical Center, Chicago, IL); William C.Cushman, M.D. (Veterans Affairs Medical Center, Memphis, TN); Lee A. Green, M.D., M.P.H. (University of Michigan, Ann Arbor, MI); Joseph L. Izzo, Jr., M.D. (State University of New York at Buffalo School of Medicine, Buffalo, NY); Daniel W. Jones, M.D. (University of Mississippi Medical Center, Jackson, MS); Barry J. Materson, M.D., M.B.A. (University of Miami, Miami, FL); Suzanne Oparil, M.D.(University of Alabama at Birmingham, Birmingham, AL); Jackson T. Wright, Jr., M.D., Ph.D. (Case Western Reserve University, Cleveland, OH) Executive Secretary Edward J. Roccella, Ph.D., M.P.H. (National Heart, Lung, and Blood Institute, Bethesda, MD) National High Blood Pressure Education Program Coordinating Committee Participants Claude Lenfant, M.D., Chair (National Heart, Lung, and Blood Institute,Bethesda, MD); George L. Bakris, M.D. (Rush Presbyterian-St. Luke’s Medical Center, Chicago, IL); Henry R. Black, M.D. (Rush PresbyterianSt. Luke’s Medical Center, Chicago, IL); Vicki Burt, Sc.M., R.N. (National Center for Health Statistics, Hyattsville, MD); Barry L. Carter, Pharm.D. (University of Iowa, Iowa City, IA); Jerome D. Cohen, M.D. (Saint Louis University School of Medicine, St. Louis,MO); Pamela J. Colman, D.P.M. (American Podiatric Medical Association, Bethesda, MD); William C. Cushman, M.D. (Veterans Affairs Medical Center, Memphis, TN); Mark J. Cziraky, Pharm.D., F.A.H.A. (Health Core, Inc., Newark, DE); John J. Davis, P.A.-C. (American Academy of Physician Assistants, Memphis, TN); Keith Copelin Ferdinand, M.D., F.A.C.C. (Heartbeats Life Center, New Orleans, LA); Ray W.Gifford, Jr., M.D., M.S. (Cleveland Clinic Foundation, Fountain Hills, AZ); Michael Glick, D.M.D. (UMDNJ—New Jersey Dental School, Newark, NJ); Lee A. Green, M.D., M.P.H. (University of Michigan, Ann Arbor, MI); Stephen Havas, M.D., M.P.H., M.S. (University of Maryland School of Medicine, Baltimore, MD); Thomas H. Hostetter, M.D. (National Institute of Diabetes and Digestive and Kidney Diseases,Bethesda, MD); Joseph L. Izzo, Jr., M.D. (State University of New York at Buffalo School of Medicine, Buffalo, NY); Daniel W. Jones, M.D. (University of Mississippi Medical Center, Jackson, MS); Lynn Kirby, R.N., N.P., C.O.H.N.-S. (SanofiSynthelabo Research, Malvern, PA); Kathryn M. Kolasa, Ph.D., R.D., L.D.N.
iii

(Brody School of Medicine at East Carolina University, Greenville, NC); StuartLinas, M.D. (University of Colorado Health Sciences Center, Denver, CO); William M. Manger, M.D., Ph.D. (New York University Medical Center, New York, NY); Edwin C. Marshall, O.D., M.S., M.P.H. (Indiana University School of Optometry, Bloomington, IN); Barry J. Materson, M.D., M.B.A. (University of Miami, Miami, FL); Jay Merchant, M.H.A. (Centers for Medicare & Medicaid Services, Washington, DC);...
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