BOTTOM LINE
The British Hypertension Society guidelines (BHS-IV) and the American Joint National Committee guidelines (JNC-7) are very similar in treatment goals. However, the BHS-IV guidelines do not require treatment until both the systolic and diastolic numbers are greater than 160/100 mm Hg, respectively, for patients without cardiovascular disease, diabetes, or other organ damage, whereas the JNC-7 guidelines start drug treatment in all patients with both numbers greater than 140/90 mm Hg. The BHS-IV suggests initial treatment with any 1 of 4 drugs (see the ABCD rule in the synopsis), whereas the bedrock of treatment recommended by the JNC-7 is diuretics, primarily because of the lower cost. (LOE=5)