To the Editor.—I would like to add a comment about a frequent cause of "urgent hypertension" as discussed in the insightful article in the February 1989 issue of the Archives1 "How Urgent Is Urgent Hypertension?" The cause is poor compliance, which too often may be related to the cost of medication.2
Today, patients with chronic diseases such as hypertension may have to pay as much as $1000 to $2000 each year just for their medications. When we write a new prescription for a particular blood pressure medication, we may be committing the patient to $5000 to $10 000 of additional out-ofpocket expenses over the next 5 years. For us it is a flick of a pen; for the patient it could be a major financial burden. It is time that we become more sensitive to costs of medication. After all, it seems pointless to spend hours of
SHULMAN NB. Urgent Hypertension. Arch Intern Med. 1989;149(9):2139. doi:10.1001/archinte.1989.00390090151033
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