Undertreatment of Hypertension: A Dozen Reasons
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We read with interest the Cohen1 editorial
in a recent issue of the ARCHIVES. Despite a better understanding of the benefits
of controlling hypertension, both the second2 and
third3 National Health and Nutrition Examination
Surveys show that blood pressure (BP) control in over 70% of patients remains
inadequate. It is widely recognized that strict control of BP is closely related
to the prevention of long-term complications of hypertension. More than 3
years ago, the researchers of the Hypertension Optimal Treatment (HOT) trial4 involving 19 000 patients concluded that the
greatest benefit in reducing adverse events was seen in patients whose BP
was reduced to 130 mm Hg systolic and 83 mm Hg diastolic. The problem of inadequate
BP control has been highlighted by several studies. In the Treatment of Mild
Hypertension Study (TOMHS),5 only 72% of
patients reached a diastolic BP goal of 90 mm Hg. At the initial enrollment
of . . . [Full Text of this Article]
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