Will better-tolerated antihypertensive agents improve blood pressure control? JNC VI revisited.

Although we have incontrovertible evidence for the benefits of treating hypertension, only a minority of Americans with this disorder have blood pressure readings at the levels currently recommended by the Sixth Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Recent trials have shown that if physicians set a goal, they can regularly reduce blood pressure to suggested levels using standard therapy. The barriers to reaching that goal in practice can be overcome if well-tolerated agents are used, if the importance of adherence to the regimen is emphasized and effectively conveyed, and if practitioners utilize the services of hypertension specialists should a goal not be reached. The availability of newer agents that are virtually free of side effects and the clear understanding of the value of aggressively managing hypertension make it imperative that all clinicians understand how to most effectively use the many tools available.