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Why in 2016 are patients with hypertension not 100% controlled? A call to action

Redon, Josep; Mourad, Jean-Jacques; Schmieder, Roland E.; Volpe, Massimo; Weiss, Thomas W.

doi: 10.1097/HJH.0000000000000988

The objective is to consider the problem of high blood pressure (BP), a leading global risk factor, associated with substantial morbidity and mortality. Despite the availability of treatment guidelines and a wide range of therapies, BP control is suboptimal in many countries. Recent data indicate that only around 40% of patients manage to achieve an adequate level of BP control. A group of international experts in the field of hypertension met in 2008 to consider this problem. The resulting white paper delivered an urgent call to action and identified six key issues for improving BP control. In 2015, a working group of investigators spontaneously undertook an action with the primary aim of considering the current hypertension management situation in Europe, to discuss whether the situation had changed since 2008 and to determine what can be learnt from the projects in other continents, such as the Canadian Hypertension Education Program, which has shown that higher levels of BP control can be achieved across a general population. The working group identified the main challenges affecting the improvement of BP control today and suggests five key actions: identify the BP treatment target of less than 140/90 mmHg for the majority of patients, simplify treatment strategies and encourage pill reduction, decrease therapeutic inertia, improve patient empowerment, and involve healthcare systems and reduce the prevailing focus on drug costs in many healthcare systems. Implementing key actions identified by the working group may help to improve achievement of better BP control across Europe.

aINCLIVA Research Institute, University of Valencia and CIBERObn ISCIII, Valencia, Spain

bUnite Médecine Interne – HTA and CHU Avicenne, Paris, France

cUniversity Hospital of the Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany

dUniversity of Rome ‘Sapienza’, Rome

eIRCCS Neuromed, Pozzilli, Italy

f3rd Medical Department, Wilhelminenhospital, Vienna, Austria

Correspondence to Professor Josep Redon, INCLIVA Research Institute, University of Valencia and CIBERObn ISCIII, Avenida de Menéndez y Pelayo, 4, 46010 Valencia, Spain. Tel: +34 961 97 35 17; e-mail:

Abbreviations: BP, blood pressure; CHEP, Canadian Hypertension Education Program; ESC, European Society of Cardiology; ESH, European Society of Hypertension

Received 11 April, 2016

Revised 19 April, 2016

Accepted 4 May, 2016

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