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Hypertension Controlled Better in U.S. than in Europe
Written by Jeanne Bohm, Ph.D.   

U.S. patients with diagnosed hypertension appear to have lower blood pressures and better hypertension control than Western European patients, according to a report in the January 22 issue of Archives of Internal Medicine.

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Studies suggest that hypertension is under-diagnosed and under-treated in the United States and Europe, but treatment is more aggressive in the United States.

Y. Richard Wang, M.D., Ph.D., of Temple University Hospital and University of Pennsylvania, and colleagues analyzed data from a survey of cardiologists and primary care physicians in the United States and five Western European countries: France, Germany, Italy, Spain and the United Kingdom who had patients with hypertension. The physicians in the survey completed two-page diaries for 15 cardiovascular patients. Information collected included patient characteristics, initial blood pressure level before treatment, any co-occurring diseases and the use of seven types of antihypertensive drugs.

At least 92% of patients with hypertension were receiving medication for high blood pressure. The initial blood pressure level before treatment was lowest in the United States (average of 161/94 mm Hg, vs. an average of 167 to 173/96 to 99 in Europe). Only 65% of U.S. patients had a pre-treatment blood pressure level of 160/100 mm Hg or higher, compared with 81 to 90% of European patients.

Hypertension control (140/90 mm Hg or lower) was best in the United States (63% vs. 31 to 46% of patients across European countries). In 11,969 patients with inadequately controlled hypertension, the United States had the highest percentage of patients receiving a medication increase (38% vs. 15 to 28% across European countries).

The authors concluded that better hypertension control in the United States may be due to lower treatment thresholds and more aggressive treatment guidelines.


JAMA and Archives Media Release

Outpatient Hypertension Treatment, Treatment Intensification, and Control in Western Europe and the United States. Arch Intern Med. 2007;167:141-147.

About the Author

Jeanne Bohm, Ph.D. is a cancer biologist by training, a medical writer and an experienced science educator.

The author has no financial relationship to any of the companies listed in the article.

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