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March 24, 2003

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

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.

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