Hypertension--unexpected research results and program redirection

The California Department of Health Services (DHS) has conducted two statewide surveys to evaluate the effectiveness of a coordinated hypertension control program. Unfortunately, the expected reduction in the prevalence of elevated blood pressure did not occur. Public knowledge about hypertension did increase, but among hypertensive persons awareness, treatment, and control did not improve. The responses to several survey questions were examined to determine why there was no improvement in the rate of control of elevated blood pressure. Obviously, many persons with hypertension have not complied with medical advice at various points in the hypertension control system. Consequently, the DHS is redirecting its Hypertension Control Program. Less emphasis is being placed on the coordination of blood pressure control resources, including public education, while more emphasis is being placed on increasing compliance with treatment recommendations, focusing on patient tracking as described by the National High Blood Pressure Education Program and long-term adherence to therapy as discussed in the 1984 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure.