LipidManagement™ is certified for CME credit. PLEASE NOTE: LipidManagement™ now offers 1 category 1 credit toward the AMA Physician’s Recognition Award FOR EACH OF THE QUARTERLY ISSUES. Readers can apply for instant CME credit quarterly. Simply click on the “LipidManagement™ Newsletter” navigation bar. Then just click on the link for the current issue’s CME test, answer the questions, and apply for instant credit. LEARNING OBJECTIVES After reading the articles in this issue of LipidManagement™, participants should be able to: • Summarize the associations between a patient's lifestyle and development of the metabolic syndrome • Diagnose and treat the metabolic syndrome through management of lipids and other contributing factors • Apply clinical trial results and new guidelines to the management of dyslipidemic patients with hypertension Intended audience: primary care physicians, cardiologists, endocrinologists, nephrologists Release date: June 30, 2003 End date: June 30, 2004 This CME activity is sponsored by Thomson Professional Postgraduate Services®, Secaucus, NJ.      Thomson Professional Postgraduate Services® is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.      Thomson Professional Postgraduate Services® designates this educational activity for a maximum of 1 category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.

JNC 7: New BP Guidelines Are Issued The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) recently provided new recommendations for prevention and management of hypertension (identified as a major risk factor for CHD by the National Cholesterol Education Program Adult Treatment Panel III guidelines).1 Treatment is determined by the average of the two highest blood pressure readings obtained at each of two or more physician-office visits. Key messages from the report include: Systolic/diastolic BP. In individuals older than 50 years of age, systolic BP >140 mm Hg is a “much more important” CVD risk factor than diastolic BP. CVD risk. The risk of CVD, beginning at 115/75 mm Hg, doubles with each increment of 20/10 mm Hg; individuals who are normotensive at age 55 have a 90% lifetime risk for developing hypertension. New category. Individuals with a systolic BP of 120–139 mm Hg or a diastolic BP of 80–89 mm Hg should be considered prehypertensive, reflecting an increased risk of future hypertension and requiring health-promoting lifestyle modifications to prevent CVD. Treatment choice. Thiazide-type diuretics should be used as drug therapy for most patients with uncomplicated hypertension, either alone or in combination with agents from other classes. Certain high-risk conditions, including postmyocardial infarction, diabetes, and chronic kidney disease, are compelling indications for the initial use of other antihypertensive drug classes (ie, ACEI, ARB, BB, CCB). Combination therapy. Most patients with hypertension will require two or more antihypertensive drugs to achieve goal BP (<140/90 mm Hg, or <130/80 mm Hg for patients with diabetes or chronic kidney disease). If BP is >20/10 mm Hg above goal BP, consider initiating therapy with two agents, one of which should usually be a thiazide-type diuretic. Judgment is paramount. A physician’s judgment remains paramount to these guidelines. JNC 7: Treatment Algorithm for Hypertension 1. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). May 2003. NIH publication 03-5233.