• Stephen A. Brunton
  • Rita K. Edwards


Despite widespread efforts to improve education and enhance public awareness, 30 million to 40 million of the approximately 60 million hypertensives in the United States remain undiagnosed or are inadequately treated (Table 78.1). Most have mild hypertension, and controversy still exists concerning the appropriate approach to these patients. Nonpharmacologic therapy is often the first choice, and this approach continues to evolve.1Of the 20 million to 30 million hypertensives who receive pharmacologic therapy, fewer than 50% adhere to their therapeutic regimen for more than 1 year, and 60% of these patients reduce the dosage of their drug owing to adverse effects. A negative impact on the patient’s quality of life may occur as a result of just making the diagnosis. Effects such as increased absenteeism, sickness behavior, hypochondria, and decreased self-esteem have been noted in cohorts of previously well individuals who have been told they were hypertensive.2A 1987 survey of physicians revealed that they regarded quality of life changes to be the primary impediment to effective pharmacologic treatment of hypertension.


Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease Patient Total Peripheral Resistance Life Style Modification Step Care Approach 
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© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Stephen A. Brunton
  • Rita K. Edwards

There are no affiliations available

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