Hypertension remains a significant public health problem globally and effective control of blood pressure continues to challenge healthcare professionals working in primary care. Despite the availability of a wide range of effective drugs, the strong evidence base underpinning their use and an increasing acceptance of combination therapy, control of blood pressure remains woefully inadequate in practice. For example, it has been estimated that fewer than 10% of patients have their blood pressure controlled under the 140/85 mmHg target. This situation has not been helped by the conflict that exists between current management guidelines and the difficulty of implementing the rapidly evolving evidence base into practice.
ASCOT set out to understand why there was a shortfall in terms of CHD events compared with what could be predicted from observational and epidemiological data and also to evaluate whether newer agents would have a greater impact on CHD events than older classes of antihypertensives.
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