At least fifty million people in America have hypertension. Of these people, one-third, or about sixteen million, are unaware of their disease. These are very sobering statistics, since heart disease and stroke, directly caused by hypertension, cost approximately two hundred and sixty billion dollars annually, and more important, cost immeasurably more in human suffering and unhappiness. Similarly, anyone who is on treatment for hypertension should take their BP as well, to ensure control. Lifestyle modifications might control borderline high blood pressure without medication, or make it easier to treat blood pressure with medication.
Smoking cessation is paramount since nicotine multiplies the risks of having high blood pressure.
In other words, diabetics with untreated hypertension and high cholesterol, who also smoke, guarantee an adverse outcome for themselves. We are in the best of times when it comes to treating blood pressure. This means that all but the most impoverished of our patients can afford lifelong medications, and probably get good control of their blood pressure. I would rather my patients nag me about poor blood pressure control than ignore the problem. Clearly, it is the responsibility of both of us.