Using Public Health Indicators to Measure the Success of Hypertension Control

Hypertension is widely recognized as a public healthmenace but rarely treated as one. In many ways, thechallenge of hypertension reflects a transition from classic public health strategies that have been applied to control microbial epidemics to a fully medicalized approach requiring individual doctor–patient encounters. One reason why hypertension has perhaps not been seen as a legitimate public health problem is the unavailability of good surveil-lance measures that can describe disease burden. Although we have abundant information about the relative risk associ-ated with various levels of blood pressure and the benefit to be gained from treatment, it had not been possible until recently to relate levels of hypertension treatment and control in a specific population to rates of cardiovascular sequelae. Reasonable evidence suggests that increased levels of treatment of cardiovascular (CV) risk factors have been associated with declines in CV mortality.1,2 The most recen