Self-reported Hypertension Treatment Practices Among Primary Care Physicians

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Abstract
HYPERTENSION IS the number one diagnosis for office visits to primary care physicians in the United States.1 The definition of hypertension control in national health surveys since 1980 has been a systolic blood pressure (SBP) of less than 140 mm Hg and a diastolic blood pressure (DBP) of less than 90 mm Hg.2 In 1988, the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC) added an SBP of less than 140 mm Hg and a DBP of less than 90 mm Hg as the recommended treatment goal.3 How physicians treat hypertension affects rates of hypertension control in the population and health care costs. After decades of steady improvement in hypertension control in the general population, it appears that after 1990 this trend has leveled off, and may have declined slightly by the early 1990s.4 At the peak of control recorded in the first phase of the third National Health and Nutrition Examination Survey (1988-1991), 73% of patients with hypertension were aware of having hypertension; in 29%, the hypertension was controlled.5