Table 1.

Use of CVD Risk in Conjunction With BP Level in Guiding Antihypertensive Medication Treatment in the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC6)

BP, mm Hg		≥1 Risk Factor, But Not
SBP	DBP	No Risk Factors, Organ Damage or Clinical CVD	Diabetes, Organ Damage, or Clinical CVD	Organ Damage, Clinical CVD, or Diabetes
130–139	85–89	Lifestyle modification	Lifestyle modification	Drug therapy*,†
140–159	90–99	Lifestyle modification (up to 12 months)	Lifestyle modification‡ (up to 6 months)	Drug therapy†
≥160	≥100	Drug therapy†	Drug therapy†	Drug therapy†

Organ damage includes left ventricular hypertrophy, angina, prior myocardial infarction, prior coronary revascularization, heart failure, stroke, transient ischemic attack, nephropathy, peripheral arterial disease, retinopathy. Risk factors include age ≥60 years, male sex or being post-menopausal for women, smoking, dyslipidemia, diabetes mellitus, family history of CVD. Adapted from: National Institutes of Health, National Heart, Lung, and Blood Institute, National High Blood Pressure Education Program (90).

^*For patients with heart failure, renal insufficiency, or diabetes.

^†Lifestyle modification is adjunctive for all patients recommended drug therapy

^‡Patients with multiple risk factors should be considered for drug therapy as initial therapy in conjunction with lifestyle modification. CVD = cardiovascular disease; BP = blood pressure; DBP = diastolic blood pressure; SBP = systolic blood pressure.