The impact of hypertension in the middle years.

Hypertension is a prevalent condition in the middle years. About 25% of visits to family physicians are by patients with hypertension. Both case-detection and control of hypertension are important parts of practice. Unfortunately, the criteria used to diagnose and treat hypertension are variable, partly because of the lack of agreement on the need to treat mild hypertension. Patients have a fairly good knowledge of hypertension, but many think it is caused by, or the same thing as, nervous tension. The diagnosis and treatment of hypertension frequently have adverse effects on patients. These effects include increased absences from work, psychological distress, complaints of decreased sexual appetite and satisfaction, impotence, headaches, dizziness, fatigue, and drowsiness. Several strategies can improve patient compliance with treatment.