Hypertension can be treated effectively without increasing the cost of care.

There is little reason to believe that patients with hypertension cannot be treated effectively without increasing the cost of care. Yet costs in the United States continue to increase. It is of interest to review some of the reasons for this and to emphasize that the management of hypertension has been successfully carried out over the past 20-30 years without the use of expensive technology or complicated treatment programs. This is an important message to non industrialized nations that are starting hypertension treatment programs. Hypertension costs can be controlled by: (1) limiting the complexities of the initial evaluation, avoiding the temptation to employ technologies which have not been shown to improve outcome, and (2) by selecting therapy based on data that have been collected over the past 20 years, and not on the latest promotional efforts. In addition, there is evidence that limiting physician visits to 2, 3 or at the most 4 per year is adequate to control the majority of hypertensive patients after initial blood pressure control is obtained--another important factor in the cost of care ($). There is no evidence that a more expensive approach to management will improve outcome compared to a less costly approach.