Abstract
Recent studies have suggested that most of the patients on treatment for hypertension are not well controlled to < 140/90, as recommended by JNC-6, despite therapy. In this study we tested the hypothesis that inadequate hypertension control is mainly due to poorly controlled systolic BP and that currently available antihypertensives are not sufficient to adequately control of systolic hypertension. We identified 6,875 patients with the diagnosis of hypertension during the years 1998 and 1999 by ICD code. Out of 6,875 subjects, 487 patients were selected randomly by computer generated random numbers. The mean age was 64±12 years, and the mean number of antihypertensive medications were 1.9±1.2. Of those patients 43% were on diuretics, 34% were on calcium channel blockers, 41% were on ACE inhibitors and 21% were on vasodilators. Out of the 487 patients 45% have uncontrolled hypertension (95% confidence interval is 40-49%). Among patients with uncontrolled hypertension 73% (95% confidence interval is 67-79%) had uncontrolled isolated systolic hypertension (SBP>140 and DBP <90), and only 27% had uncontrolled diastolic BP.
