Applying hypertension guidelines to reduce the burden of heart failure.

If the recommendations of Joint National Committee 7 are implemented, the incidence of heart failure should continue to decline. These recommendations are designed not only to reduce the incidence of heart failure but also prevent other target end-organ damage and reduce overall cardiovascular morbidity and mortality. The emphasis of these recommendations is to reduce systolic blood pressure, because the risk of mortality caused by heart disease and stroke doubles for every 20-mm Hg increase in systolic blood pressure. Practitioners are encouraged to use a combination of lifestyle changes and pharmacotherapy to achieve systolic blood pressure goals and consider the use of thiazide diuretics as first-line therapy to achieve the ultimate goal of reducing end-organ damage.