Hypertension control: historic perspectives--25 years of progress in Canada and around the world

Hypertension has been estimated to affect over 15% of the general population in North America, and is a leading risk factor for coronary artery disease, congestive heart failure, stroke, kidney disease, and retinopathy. Since the early 70s there has been rapid development in the pharmacotherapy of hypertension and a concomitant effort to evaluate the efficacy of non-pharmacological interventions in controlling high blood pressure. At the same time it has become obvious that hypertension is not only a clinical but also a public health problem. Twenty five years ago only half of hypertensive patients were aware of their condition, and only 16% of the total number were under satisfactory control. In the past two decades the proportion of treated patients with well-controlled hypertension increased to over 40%. Even today, however, one third are either unaware of their condition, or the reduction of blood pressure in those treated is unsatisfactory. A continuing effort is warranted to improve the management of hypertensive patients and to develop innovative public health measures in controlling this condition at a community level.