Establishing sound goals for hypertension management

There is a clear need to reduce the prevalence of hypertension and, therefore, cardiovascular risk, among Americans. Many are unaware they have elevated BP, less than half who have been diagnosed with hypertension are treated, and only a third of those treated reach recommended goals. While hypertension affects American men and women of many ethnicities, prevalences are notably increased among blacks and Hispanics. Merely adopting positive lifestyle changes that include more exercise, a healthy, low-sodium diet for weight reduction, and smoking cessation can significantly improve both systolic and diastolic BP When pharmacologic treatment is needed, several classes ofantihypertensive agents with differing mechanisms of action are available for use as monotherapy or in various combinations to help patients reach their BP goals. Often three or more antihypertensive drugs are necessary for adequate BP control; however, the antihypertensive regimen must be tailored to the individual patient. It is more meaningful to assess and understand the individual patient with hypertension in order to set realistic BP goals than to expect all patients to reach the same goal with a uniform therapeutic plan.