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Controlling Blood Pressure in 50% of All Hypertensive Patients: An Achievable Goal in the Healthy People 2010 Report?
  1. Brent M. Egan,
  2. Jan N. Basile
  1. From the Department of Medicine (B.M.E., J.N.B.), Division of General Internal Medicine, Geriatrics and Hypertension, Medical University of South Carolina, Charleston, South Carolina; and the Primary Care Service Line (J.N.B.), Ralph H. Johnson VA Medical Center, Charleston, South Carolina.
  1. This report was supported in part by grants P01HS1087-03 (EXCEED) from the Agency for Healthcare Research and Quality, HL04290 and P60-MD00267 (EXPORT) from the National Heart, Lung, and Blood Institute, the Duke Foundation, the South Carolina Department of Health and Environmental Control, and the American Society of Hypertension.
  2. Address correspondence to: Dr. Brent M. Egan, Department of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, CSB 826H, Charleston, SC 29425; e-mail: eganbm{at}musc.edu.

Abstract

Background One important objective defined in the Healthy People 2010 report was to improve blood pressure (BP) control to < 140/90 mm Hg in 50% of all hypertensive patients. Because the US population is becoming older, more obese, and ethnically diverse, the health and economic benefits of reaching this goal become more valuable each year. Hypertension control rates are currently at ˜ 31% of all hypertensives and have risen slowly and erratically since 1988. In the absence of a coordinated strategic plan, achieving this critically important goal for BP control is highly unlikely.

Methods A selected literature review was undertaken to briefly assess the cardiovascular benefits of controlling hypertension. Greater focus was placed on variables that impact hypertension awareness, treatment, and control. The impact on hypertension control rates of theoretic changes in awareness, treatment, and control individually and collectively was examined. Four categories of potential barriers to optimizing BP control are discussed: systems, provider, patient, and treatment factors.

Results Raising awareness to 80% of all hypertensives, ensuring treatment of 90% of aware hypertensives, and controlling BP to < 140/90 mm Hg in 70% of treated patients would achieve control rates of 50%.

Conclusions The barriers to achieving the Healthy People 2010 goal of controlling hypertension in 50% of all patients are formidable but appear to be resolvable with a coordinated strategic plan. Given projected demographic changes in the United States, the health and economic benefits of attaining the national goal for hypertension control would seem to merit a serious integrated effort.

Key Words
  • Healthy People 2010
  • hypertension
  • high blood pressure

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