IN THIS ISSUE of the ARCHIVES, the article by Oliveria and colleagues1 sheds light on an important subject: Why doctors do not treat hypertension in accordance with current guidelines. This subject takes on special significance for 3 reasons: (1) an estimated 50 million Americans have hypertension, which is the leading cause for physician visits2; (2) even modest elevations of blood pressure (BP) are associated with excess morbidity and mortality from coronary disease, cerebrovascular disease, congestive heart failure, and renal disease3; and (3) treatment has shown that the associated morbidity and mortality can be significantly reduced.4 Given these facts, it is hard to understand why our health care system is not accomplishing more in the recognition, treatment, and control of hypertension.