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Is blood pressure control to less than 140/less than 90 mmHg in 50% of all hypertensive patients as good as we can do in the USA: or is this as good as it gets?

Egan, Brent Ma; Laken, Marilyn Ab

Current Opinion in Cardiology: July 2011 - Volume 26 - Issue 4 - p 300–307
doi: 10.1097/HCO.0b013e3283474c20
Hypertension: Edited by William J. Elliott

Purpose of review This review assesses whether controlling hypertension in 50% of all patients is the best we can do.

Recent findings NHANES 2007–2008 data show that blood pressure was controlled to less than 140/less than 90 mmHg in 50% of all hypertensive patients, an increase from 27% in 1988–1994. The 50% control rate reflects the product of 72.5% of all patients treated and 69% of all treated patients controlled. However, there are opportunities for improvement, as 27.5% of all hypertensives, or 55% of uncontrolled patients, were untreated in 2007–2008. These individuals are disproportionately younger, men, and Hispanic. Moreover, 31% of all treated hypertensives, or 45% of uncontrolled patients, have blood pressure of at least 140/at least 90 mmHg. They are disproportionately older, women, and black.

Summary Initiatives to raise hypertension treatment from 72.5% in 2007–2008 to 87.5% in the future are conceivable by targeting unaware and untreated patient groups and engaging them in ongoing healthcare. This could improve hypertension control by an absolute 10% of all patients. Reducing therapeutic inertia and increasing therapeutic efficiency could raise the proportion of patients on treatment who are controlled from 69 to 80% and could increase hypertension control by 8%. Combining these approaches could raise hypertension control to 70% of all hypertensive adults in the USA.

aDepartment of Medicine

bCollege of Nursing, Medical University of South Carolina, Charleston, South Carolina, USA

Correspondence to Brent M. Egan, MD, 135 Rutledge Avenue, RT12130, Charleston, SC 29425, USA Tel: +1 843 792 1715; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.