ArticlePractical solutions to the challenges of uncontrolled hypertension: a white paperRedon, Josepa; Brunner, Hans Rb; Ferri, Claudioc; Hilgers, Karl Fd; Kolloch, Rainere; van Montfrans, GertfAuthor Information aHypertension Clinic, Internal Medicine, Hospital Clinico, University of Valencia, Valencia, Spain bLausanne University, Lausanne, Switzerland cUniversita di L'Aquila, Facolta di Medicina e Chirurgia, Dipartmento di Medicina Interna e Sanita Pubblica, Coppito, L'Aquila, Italy dDepartment of Nephrology and Hypertension, University of Erlangen-Nuremberg, Erlangen, Germany eEvangelisches Krankenhaus Bielefeld, Klinik fur Innere Medizin, Kardiologie, Nephrologie und Pneumologie, Bielefeld, Germany fDepartment of Vascular Medicine, Academic Medical Centre, Amsterdam, the Netherlands Correspondence and requests for reprints to Josep Redon, Hypertension Clinic, Internal Medicine, Hospital Clinico, University of Valencia, Avda Blasco Ibañez 17, 46010 Valencia, Spain Tel: +34 963862647; fax: +34 963862647; e-mail: firstname.lastname@example.org Sponsored by DAIICHI SANKYO Europe GmbH, who had no content editorial control. DAIICHI SANKYO Europe GmbH provided financial support to the authors for out of office expenses and to Huntsworth Health for writing support. A special acknowledgement is made to Colleen Shannon for writing support and excellent collation of author input. Conflicts of interest: HB has received consultancy fees from Daiichi Sankyo and SPEEEDEL/Novartis, and receives honoraria from Pfeizer and Bristol-Myers Squibb. KFH has received grant support as well as advisory board and speakers fees from several companies which market antihypertensive drugs, including Daiichi Sankyo, Novartis, Sanofi Aventis and AstraZeneca. Journal of Hypertension: December 2008 - Volume 26 - Issue - p S1-S14 doi: 10.1097/01.hjh.0000343507.74401.45 Buy Metrics Abstract This white paper is an urgent call to action from an international group of physicians. The continued failure to control hypertension takes an unacceptable toll on patients, families and society and it must be addressed. Any patient with blood pressure of 140/90 mmHg or greater can be characterized as a ‘challenging patient’, is at significant risk, and requires persistent optimization of therapy until target blood pressure is achieved. Six key challenges in reaching this goal blood pressure are described: (1) inadequate primary prevention; (2) faulty awareness of risk; (3) lack of simplicity; (4) therapeutic inertia; (5) insufficient patient empowerment; and (6) unsupportive healthcare systems. This white paper identifies straightforward actions that will produce rapid improvements in the management of hypertension, with a simple aim: to treat all challenging patients effectively to goal blood pressure, preventing disability and saving lives. © 2008 Lippincott Williams & Wilkins, Inc.