No Time to Waste: in Support of Aggressive and Immediate Management of Hypertension

  • Marat Fudim
  • Sreekanth Vemulapalli
Prevention of Hypertension: Public Health Challenges (P Muntner, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Prevention of Hypertension: Public Health Challenges


Untreated and uncontrolled hypertension (HTN) presents a major public health burden in the USA and worldwide. Despite the known risk for increased cardiovascular (CV) morbidity and mortality, blood pressure remains untreated and uncontrolled at alarming rates of between 20 and 40 % in patients with known HTN. Further, while cumulative evidence indicates that early onset of antihypertensive effect improves CV outcomes, the time to blood pressure (BP) control remains long. The objective of hypertension management cannot be simply to achieve and maintain the goal BP, but to do so quickly to improve short-term and long-term CV outcomes. In this review, we will (1) describe the magnitude of uncontrolled HTN, (2) identify the factors that contribute to uncontrolled BP in patients with the diagnosis of HTN, and (3) explore the rationale for and benefits of aggressive and immediate control of HTN.


Hypertension Blood pressure control Cardiovascular risk 



Blood pressure


Coronary artery disease


Chronic kidney disease




Cardiovascular disease


Diabetes mellitus




Joint National Committee


Compliance with Ethical Standards

Conflict of Interest

Dr. Fudim declares that he owns stock in Cibiem. Dr. Vemulapalli declares a grant from the American College of Cardiology.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest have been highlighted as: • Of importance

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© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of CardiologyDuke University School of MedicineDurhamUSA
  2. 2.Duke Clinical Research InstituteDurhamUSA

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