Editor—In the guidelines from the British Hypertension Society Williams et al say that the prevalence of hypertension is 42% in people aged 35-64.1 This must mean that in older patients the condition is present in well over half of the population.
With such a huge prevalence it is not surprising that control of this “disease” in the United Kingdom is so poor. Perhaps general practitioners would have been wise to calculate the time and effort (never mind the ethics) entailed in controlling the blood pressure of millions of elderly patients before accepting this aspect of the new contract for general medical services.
More importantly, has the disease model for diagnosis and treatment of hypertension been accepted by the population at large? Do people really want polypharmacy, with its attendant risks, so that they are marginally less likely to die of cardiovascular disease and so marginally more likely to die of something else? Or could it be that the dependence of the multibillion pound drug industry on antihypertensive agents is stifling the debate?
See editorial by Campbell
Competing interests: PAS is a UK general practitioner. This means that from 1 April 2004 part of his income has been related to the control of his patients' hypertension.
References
- 1.Williams B, Poulter NR, Brown MJ, Davis M, McInnes GT, Potter JF, et al. British Hypertension Society guidelines for hypertension management 2004 (BHS-IV): summary. BMJ 2004;328: 634-40. (13 March.) [DOI] [PMC free article] [PubMed] [Google Scholar]