Treating to hypertension targets.

Control of blood pressure levels in hypertensive patients often fails to meet the targets suggested by the British Hypertension Society (BHS) guidelines. The optimal treatment target for non-diabetic patients is < or = 140/85 mm Hg. Data from the health survey for England show that in 1998 only 8% of men and 11% of women had blood pressure controlled to < 140/90 mm Hg. The Anglo-Scandinavian cardiac outcomes trial (ASCOT) data show that 87% of non-diabetic patients in the St Mary's Centre are currently treated to below 140/90 mm Hg. These differences can be explained by strict protocol adherence, a focus on cardiovascular disease, longer consultation times and punctual appointments, reinforcement of non-pharmacological advice, and blood pressure readings taken in line with BHS guidelines. Some of these points might be translated into the more challenging setting of primary care.