Improving quality: lessons from the Department of Veterans Affairs.

In 1967, the first multicenter randomized controlled trial of treatment for hypertension was published by the newly created Veterans Administration Cooperative Studies Program, demonstrating the remarkable effectiveness of drug treatment for what would now be considered severe hypertension (average diastolic pressure 115 to 129 mm Hg).1 During the ensuing 4 decades, there have been remarkable strides made to improve care for this very common condition, including development of effective new drugs and acceptance of lower blood pressure thresholds and targets. It is more than fitting that the Department of Veterans Affairs (VA) should remain a leading contributor to these efforts.