CONCERNS ABOUT poor control of elevated blood pressure in the United States have been repeatedly expressed during the past several years. The 1991-1994 National Health and Nutrition Examination Survey1 reported that fewer than 30% of patients with elevated blood pressure (defined as ≥140/90 mm Hg) have their blood pressure controlled at goal levels. Results of investigations of elderly patients suggest an even lesser degree of control. Despite these seemingly poor results, there has been a remarkable decrease in the numbers of hypertensive patients who have progressed to severe hypertension or who develop strokes, congestive heart failure, or end-stage renal disease in their 40s, 50s, and 60s as a result of their hypertension.2 Although the incidence of congestive heart failure and end-stage renal disease has increased in the last 15 to 20 years, the types of patients reaching these outcomes are different than patients from years ago; they are considerably older and many have multiple comorbid conditions. Many of these patients have survived earlier myocardial infarctions, progressive hypertension, or the inexorable progression of renal disease.
Moser M. No Surprises in Blood Pressure Awareness Study FindingsWe Can Do a Better Job. Arch Intern Med. 2003;163(6):654-656. doi:10.1001/archinte.163.6.654