ABSTRACT
At the same time, a major remaining problem is the wide gap between expert recommendations and practice in effectively controlling elevated BP (Figure 16.4). The often expressed belief that this gap is entirely due to poor compliance of physicians and patients, is rather naïve. Even in interventional trials, where stepwise treatment schedules are enforced by wilful investigators according to strict protocols, BP goals are rarely achieved in more than 50-60% of patients, particularly of the complicated ones (7). Likewise the recommendation to bring BP below 130/80 mmHg in diabetic and renal patients (2) remains little more than wishful thinking (7), unless this is translated into the recommendation that, in these patients, antihypertensive treatment should already be initiated when BP is in the high-normal range (130-139/ 88-90 mmHg) (8).
