TABLE 1.

Joint National Committee Reports

	Year	Threshold	Treatment Goal	Selected Trial Evidence (Ref. #)
First (8)	1977	Diastolic 90 mm Hg	<90 mm Hg diastolic	VA (51)
Second (9)	1980	Diastolic 90 mm Hg	<90 mm Hg diastolic	HDFP (52)
Third (10)	1984	Diastolic 90 mm Hg	<90 mm Hg diastolic	MRC (53), Australian (54)
Fourth (11)	1988	Diastolic >90 mm Hg Diastolic <90 mm Hg and systolic >160 mm Hg  (isolated systolic hypertension)	<140/90 mm Hg, if possible	As above
Fifth (13)	1993	>140/90 mm Hg and isolated systolic >140 mm Hg for isolated systolic	<140/90 mm Hg, consider <130/85	SHEP 1991 (12)
Sixth (14)	1997	>140/90 mm Hg and isolated systolic >140 mm Hg for isolated systolic	<140/90 mm Hg, consider <130/85 mm Hg	Syst-Eur (55)
Seventh (1)	2003	>140/90 mm Hg and isolated systolic >140 mm Hg for isolated systolic	<140 or <90 mm Hg for DM  or CRD <130/80 mm Hg	RENAAL (56), IDNT (57)

CRD = chronic renal disease; DM = diabetes mellitus; HDFP = Hypertension Detection and Follow-up Program; IDNT = Irbesartan Diabetic Nephropathy Trial; MRC = Medical Research Council; RENAAL = Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan; SHEP = Systolic Hypertension in the Elderly Program; Syst-Eur = Systolic Hypertension in Europe; VA = Veterans Administration.