[In many hypertensive patients the systolic pressure remains uncontrolled. Is the selection of 140 mm Hg as the goal value too low?].
Despite the best preconditions, adequate control of arterial hypertension remains a stub born problem in the primary prevention area. Less than optimal control of hypertension is not confined to Germany--rather too low rates of detection and treatment have long been a problem for health care providers. But hypertensive treatment also inadequately succeeds in lowering systolic pressure to below the target level of 140 mmHg. Close study of the data provided by clinical trials also reveals that even intensified treatment, including the use of combinations of drugs and increased doses of antihypertensives, fails to reduce the systolic value to below 140 mmHg, while the elevated diastolic values can be brought down in more than 90% of the cases. These facts suggest that the practical significance of the target systolic value needs to be discussed. The wish to achieve the best possible control should not tempt us to close our eyes to the realistic potentials--and limitations--of medical care.
Hense
H W
HW
Inst. für Epidemiologie und Sozialmedizin, Universitätsklinikum Münster. hense@uni-muenster.de
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013599:Systole / Q000187:drug effects; D016896:Treatment Outcome
D000959:Antihypertensive Agents