Advances in the community control of hypertension: from epidemiology to primary care practice.
OBJECTIVE
To review the progress in hypertension control in the United States since 1972, to examine the factors that contributed to that progress and to consider areas in which further improvement is required.


METHODS
A review of epidemiological, clinical and health services research related to hypertension control was conducted. We report our experience in evaluating hypertension control in a multi-ethnic community clinic population as an illustration of the challenges of hypertension management in primary care practice.


RESULTS
Hypertension prevalence in the United States population has remained relatively stable, whereas actual blood pressure levels in the population have declined slightly. Most Americans (approximately 80%) have had a blood pressure check within the past year, but the rate of blood pressure control in treated hypertensives has been disappointing. The current diagnostic and therapeutic criterion of blood pressure < or = 140/90 mmHg, regardless of individual patient characteristics (e.g. age, race), should be re-evaluated.
Vallbona
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Department of Community Medicine, Baylor College of Medicine, Houston, Texas 77030.
Pavlik
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D000553:Ambulatory Care; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001294:Attitude to Health; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D015995:Prevalence; D011320:Primary Health Care; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D000959:Antihypertensive Agents