By contrast, the earlier guidelines suggested that such patients should try lifestyle changes for only three to six months before starting medication. Regardless of risk group, JNC VI recommends lifestyle changes for all patients on drug therapy. About 50 million U.S. adults have hypertension. Untreated hypertension can damage the kidneys and lead to stroke, heart attack and heart failure. The systolic pressure is the pressure of blood in the vessels when the heart contracts.
Diastolic pressure is the pressure of the blood between heartbeats when the heart is at rest.
For patients with uncomplicated hypertension, JNC VI recommends diuretics and beta blockers as the first line of treatment. Other drugs, sometimes in combination with diuretics or beta blockers, are available to treat patients with complications. For the first time, the hypertension guidelines establish compelling indications for specific drugs when patients have certain clinical conditions. For example, older people with isolated systolic hypertension should first be treated with diuretics. Patients with diabetes, kidney damage and high blood pressure should begin treatment with ACE inhibitors.