The evolving paradigm of hypertension

Although it is convenient to think of hypertension in its renal, epidemiologic, and vascular eras, a new perspective is rapidly coming to the forefront. As we become more critical in evaluating the performance of our health care systems, it is obvious that the major problems in hypertension do not lie entirely with unsolved problems of physiology or therapeutics. Rather, we have come to realize that a large number of our hypertensive patients remain inadequately treated or, even more commonly, are receiving no treatment at all. Outcomes research into strategies for enhancing patient compliance with treatment and research dealing with other issues associated with clinical effectiveness are emerging as leading priorities.