Protocol-Based Treatment of Hypertension

Abstract

Improved treatment of hypertension is among the most important—and quite possibly also the single most neglected—area of clinical medicine. Only half of Americans with hypertension have blood pressure less than 140/90 mm Hg, and more than 13%—an estimated 9 million people—have a systolic blood pressure of 160 mm Hg or higher and/or diastolic pressure of 100 mm Hg or higher.1 Much better control is possible: Canada has a rate of blood pressure control of more than 65%,2 and the Minneapolis-St Paul region has a level of blood pressure control more than 20 percentage points higher than the United States as a whole.3 The United States is making progress, but this progress is painfully slow—the rate of control is increasing only 1% per year.4