We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Commentary |

Let’s Prioritize the Right Care for the Right Patients With Hypertension

Paul Arthur James, MD1
[+] Author Affiliations
1Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City
JAMA Intern Med. 2014;174(8):1261-1262. doi:10.1001/jamainternmed.2014.1000.
Text Size: A A A
Published online


High-quality health care is often summarized as delivering the right care to the right patient every time. In this issue of JAMA Internal Medicine, Rodriguez and colleagues1 publish an important study using data from the Atherosclerosis Risk in Communities (ARIC) Study to further inform the debate about which patients should receive antihypertensive medicines every time to achieve goal blood pressure (BP) targets—but it also informs us about much more in the treatment of hypertension (HTN). This observational study among patients with HTN finds no additional risk among the participants in the standard systolic BP (SBP) cohort (120-139 mm Hg) compared with those in the low SBP cohort (<120 mm Hg). This finding differs from epidemiologic data that consistently suggests a linear relationship between rising SBP in a population and increasing rates of poor outcomes (eg, stroke, myocardial infarction [MI], heart failure [HF], and mortality). Based on this strong epidemiologic association, conventional wisdom has held that using medication to achieve lower BPs in patients with HTN should result in lower rates of stroke, MI, and HF, similar to those seen among persons who take no antihypertensive medications.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Original Article: Does This Patient Have a Hemorrhagic Stroke?

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Quick Reference