Improved hypertension management and control - results from the Health Survey for England 1998

A survey in 1994 showed that among the 20% of the adult English population who were identified as hypertensive, approximate to 30% had their blood pre ssures controlled to <160 mm Hg systolic and <95 mm Hg diastolic. The 1998 Health Survey for England data update the 1994 findings in light of new thr esholds and targets for treatment outlined in recent national and internati onal guidelines. This cross-sectional survey is analyzed to describe the pr evalence, awareness, treatment, and control of hypertension in a random, na tionally representative sample of 11529 English adults (greater than or equ al to 16 years) living in noninstitutional households in 1998 and to compar e these rates with those from 1994. In 1998, 20% and 37% of adults were hyp ertensive according to the old (systolic greater than or equal to 160 mm Hg or diastolic greater than or equal to 95 mm Hg) and new (systolic greater than or equal to 140 mm Hg or diastolic greater than or equal to 90 mm Hg) definitions, respectively. Corresponding values in 1994 were 20% and 38%. T reatment and control rates among hypertensive adults (new definition) impro ved from 26% to 32% and from 6% to 9%, respectively, although 60% of those on treatment received only 1 antihypertensive drug in both years. Among per sons with controlled hypertension, 59% reported having received nonpharmaco logical advice from their physicians in 1998 compared with 30% in 1994. Rat es of hypertension treatment and control have increased significantly (P=0. 05 and P<0.01, respectively) since 1994 but remain low by international sta ndards. The 1998 data suggest that improved detection, greater use of nonph armacological measures, and increased use of >1 antihypertensive agent per patient would produce greater success in achieving target levels. This coul d lead to major reductions in fatal and nonfatal cardiovascular events.