Hypertension detection and control: population and policy implications.
The decline in cardiovascular diseases is by far the most remarkable achievement of medicine in the last half of the twentieth century. It can even be said that the treatment of hypertension is the only known medical intervention to have left a clear imprint on mortality trends. Much more remains to be accomplished, however, before even the majority of patients in the United States will be controlled with pharmacologic therapy [27,28]. Significant changes are needed to improve the practice of institutions, the adherence of physicians to appropriate guidelines, and the consistency of pill taking on the part of patients. Global risk evaluation is currently being used more widely in clinical practice to target therapy and improve its overall effectiveness; however, it is perhaps too early to assess its practical value. On theoretic grounds alone, much more needs to be done to refine prediction of cardiovascular risk as a clinical tool. Improvement in information technology, including an electronic medical record and on-line risk equations, will also be required before its full value can be realized.
Cooper
Richard S
RS
Department of Preventive Medicine and Epidemiology, Loyola University Medical School, 2160 S. First Ave, Maywood, IL 60153, USA. rcooper@luc.edu
Durazo-Arvizu
Ramon
R
D005260:Female; D006291:Health Policy; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000208:ethnology / Q000517:prevention & control*; D008297:Male; D012959:Socioeconomic Factors