Controlling Hypertension: We Have the Tools—We Just Need to Use Them

Excerpt

Blood pressure control among treated hypertensives has been improving in recent decades. Poor control in the past was largely attributed to “clinical inertia”—i.e., clinicians not increasing or adding antihypertensives in the face of uncontrolled blood pressure (BP), with nonadherence accounting for only 13% of the poor control.1 Physicians are now much more likely to add a second or third drug to reach the BP treatment target of less than 140/90 mmHg. Although BP control is usually achieved with three-drug therapy, some studies have suggested that many patients on three drugs, including a diuretic, were not controlled, and therefore potentially met criteria for resistant hypertension. Several studies published between 2003 and 2008 found that about 10% of all treated hypertensives on three or more drugs had uncontrolled BP.2 Thus, with over 80 million treated hypertensives in the US alone, there appeared to be a vast number of people who could benefit from further intervention and a huge market for new drugs or technologies that were proven to be effective. …