Hypertension represents a major public health concern. It affects about a billion people worldwide and is the most common treatable risk factor for cardiovascular disease in patients aged over 50. In the United Kingdom, the prevalence of hypertension (blood pressure more than 140/90 mm Hg) has been estimated to be 42% in people aged 35 to 64.1 Large benefits, in terms of avoided cardiovascular disease, are expected from the treatment of hypertension. However, these benefits are low because the control of hypertension remains poor in European countries—particularly in the United Kingdom, where it is controlled in only 10% of the hypertensive population.2

These past years, a huge quantity of novel data has been published on the prominent role of lowering blood pressure in the reduction of cardiovascular disease and on the safety and effectiveness of antihypertensive drugs. Two guidelines for management of hypertension, updating previous ones, were published in 2003.3 4 They originate from the European Societyof Hypertension/European Society of Cardiology5 and the US Joint National …