JNC 7 Speaker Remarks, Edward J. Roccella, Ph.D., M.P.H.

Edward J. Roccella, Ph.D., M.P.H.
National High Blood Pressure Education Program
National Heart, Lung, and Blood Institute
National Institutes of Health

Press Conference Remarks
May 14, 2003

Release of the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7)

Thank you Dr. Chobanian.

This morning, we've heard the recommendations of the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. May is National High Blood Pressure Education Month, a fitting time for the National Heart, Lung, and Blood Institute to issue these recommendations.

I'm going to talk about what these new guidelines mean for the public and patients, and about what the Institute and the National High Blood Pressure Education Program are and will be doing to insure that Americans can take advantage of this new information. A key part of these efforts is an ambitious new initiative called "Mission Possible" to alert Americans to the dangers of high blood pressure and to make it easier for them to lead a heart-healthy lifestyle. I'll explain this initiative in a moment.

First, the new category "prehypertension" reflects our better understanding of the true risk of rising arterial blood pressure and the damage it causes, long before hypertension is established. This means that adopting lifestyle changes, which have been shown to reverse or slow the progressive rise in blood pressure, is critical in preventing as well as controlling hypertension and its cardiovascular complications. About 22 percent of American adults, or 45 million persons, have "prehypertension" and are at increased risk for developing not only hypertension but also stroke, coronary heart disease, heart failure, and kidney disease. The important lifestyle changes Americans can make are: maintain a healthy weight; be physically active; if you drink alcoholic beverages, do so in moderation; follow a heart-healthy eating plan, which includes limiting the amount of sodium in your diet; and do not smoke. The guidelines encourage those in the new normal category to adopt these measures as well.

Next, those who already have high blood pressure need to adopt these lifestyle measures as part of their treatment. This may reduce the amount of medication needed to achieve goal therapy, can make the medications work better, and may keep the condition from worsening. The guidelines also stress that it is important for patients to work with their doctor on a treatment plan. Patients should ask their doctor for their blood pressure numbers and, if they are not at their goal blood pressure, work out a timetable for achieving it. They should be sure they understand both the condition and its treatment.

But to have an effect on Americans' health, this new knowledge must be put into practice. To help Americans do that, the Institute and the National High Blood Pressure Education Program have developed a variety of user-friendly resources. These include Web pages so people can easily obtain this information and public, patient, and professional education materials which can also be ordered through the mail. Copies of two booklets – on the DASH eating plan and lowering blood pressure – are available at the press table outside this room. In your press kit, you'll find information about the special Web pages. One, called "Your Guide To Lowering High Blood Pressure," offers patients and the public an A to Z primer about how to prevent and control high blood pressure. Another special Web page, available through the National High Blood Pressure Education Program page, has materials to help health care providers implement the guidelines, including the JNC 7 report, a reference card for clinicians, JNC 7 teaching slides, and patient handouts.

The Institute also has developed resources to assist communities to take local action on the recommendations, especially to help those with prehypertension. The resources can be used by local groups such as civic organizations and faith-based organizations to stage such activities as blood pressure screenings, cooking demonstrations, and health fairs, and include education handouts and news briefs to be used in radio programming and online through the Healthbeat radio network. Mortality maps to show areas hit hard by heart disease and stroke are also online to help communities develop area-wide plans. These too are available through a special National High Blood Pressure Education Month Web page.

But heart-healthy lifestyle changes can be easier to make and maintain when there is a supportive environment. To encourage a more heart-healthy environment, the Institute is planning an innovative effort called "Mission Possible," which has been designed to make good health as well as good business sense. We will ask groups across the country and in every sector of society – private, public, and voluntary – to join our Mission Possible team and undertake activities to fight hypertension. This includes businesses, schools, community groups, the food and hospitality industries, faith-based organizations, insurance and health care organizations, and of course health care professionals.

Businesses can put heart-health messages on paychecks or sponsor company walking clubs; restaurants can reduce the sodium in their meals; HMOs can reward those who lower their blood pressure with lowered health premiums. Together, these activities can create a heart-friendly environment. The Institute plans to have a special Mission Possible Web page and resources available for use in these efforts.

Also to make the environment more supportive of heart health, the Coordinating Committee of the National High Blood Pressure Education Program has endorsed a resolution from the American Public Health Association that calls for a reduction of sodium in U.S. foods of 5 percent annually for 10 years. While more lower salt food choices are now available, there is still a long way to go. The APHA resolution calls for a modest but long-term sodium reduction, which could help Americans in their efforts to prevent and control high blood pressure. By slowly reducing sodium in the food supply, Americans can begin to adjust their tastes for salt.

The new guidelines ask Americans to change how they think about high blood pressure. The risk for heart disease and stroke starts to rise long before hypertension is established. Americans can't wait for that risk to overtake them. They need to start today to make the lifestyle changes that can protect them.

Now I'll hand the proceedings back to Dr. Lenfant for the question period. Thank you.