Since publication of the JNC VI report, the NHBPEP Coordinating Committee, chaired by the director of the NHLBI, has regularly reviewed and discussed the hypertension clinical trials at their biannual meetings. In many instances, the principal investigator of the larger studies has presented the information directly to the Coordinating Committee. The Committee's presentations and reviews are summarized and posted on the NHLBI Web site.2 In agreeing to commission a new report, the director requested that the Coordinating Committee members provide in writing a detailed rationale explaining the necessity to update the guidelines and to describe the critical issues and concepts to be considered for a new report. The JNC 7 chair was selected in addition to a 9-member executive committee appointed entirely from the NHBPEP Coordinating Committee membership. The NHBPEP Coordinating Committee served as members of 5 writing teams, each of which were co-chaired by 2 executive committee members.
The concepts identified by the NHBPEP Coordinating Committee membership were used to develop the report outline. A timeline was developed to complete and publish the work in 5 months. Based on the identified critical issues and concepts, the executive committee identified relevant Medical Subject Headings (MeSH) terms and keywords to further review the scientific literature. These MeSH terms were used to generate MEDLINE searches that focused on English-language, peer-reviewed scientific literature from January 1997 through April 2003. Various systems of grading the evidence were considered and the classification scheme used in JNC VI and other NHBPEP clinical guidelines was selected,3-4 which classifies studies in a process adapted from Last and Abramson.5
The executive committee met on 6 occasions, 2 of which included meetings with the entire Coordinating Committee. The writing teams also met by teleconference and used electronic communications to develop the report. Twenty-four drafts were created and reviewed in a reiterative fashion. At its meetings, the executive committee used a modified nominal group process to identify and resolve issues. The NHBPEP Coordinating Committee reviewed the penultimate draft and provided written comments to the executive committee. In addition, 33 national hypertension leaders reviewed and commented on the document. The NHBPEP Coordinating Committee approved the JNC 7 report.

编辑 郑麓薇