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American Journal of Medical Quality, Vol. 22, No. 4, 251-258 (2007)
DOI: 10.1177/1062860607303293

Compliance With Joint National Committee 7 Guidelines in Hypertension Management in a Teaching Institution

Prasuna Jami, MD

Pamela Smith, PharmD

Shalini Moningi

Venkata Moningi, MD

Shelda A. Martin, MD

Gregory Rosencrance, MD, FACP

Bernardo J. Reyes, MD, CPI

West Virginia University, Charleston, Bernardo.reyes{at}camc.org

Aim. To assess compliance with Joint National Committee 7 (JNC 7) guidelines and evaluate target blood pressure (BP) goals among patients with hypertension. Results . Basic laboratory workup was completed on 75% of patients, and 71% received smoking cessation counseling. Overall BP goal achievement was 45.6%; it was 27.6% and 21.1% among diabetes and chronic kidney disease (CKD) patients, respectively. An average of 2.6 antihypertensive medications were prescribed per patient, with beta-blockers being the most frequently used, followed by thiazide diuretics and angiotensin-converting enzyme inhibitors (ACEIS). ACEIS or angiotensin receptor blockers (ARBs) were not prescribed for 16% of diabetics, 26% of chronic renal failure patients, or 41% of those with history of stroke. Among heart failure patients, 24.1% were not on ACEI or ARBs, and 20.7% were not receiving beta-blockers. Conclusions. Certain aspects of JNC 7 are not well incorporated into clinical practice, especially among patients with coexisting diabetes and/or CKD. (Am J Med Qual 2007;22:251-258)

Key Words: JNC 7 • compliance • teaching hospital • guidelines


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