What This Means
This study looked at more than 400,000 adults in Stockholm County, Sweden, using routine healthcare records, blood pressure readings and pharmacy dispensing data. Among people who had been diagnosed with high blood pressure, just over half (57%) had readings below 140/90 mmHg by the end of 2019. Only about one in five (19%) reached the stricter target of 130/80 mmHg, which many current guidelines recommend for many patients.
The study also estimated how common treatment-resistant hypertension is, meaning blood pressure that stays high despite multiple medications. The estimate ranged from under 1% to 17% depending on which of three commonly used definitions was applied, suggesting that differences in definitions may help explain why earlier studies reported such different numbers. People with treatment-resistant hypertension tended to be older, to have a higher body mass index, and to have conditions such as type 2 diabetes, cardiovascular disease, heart failure and chronic kidney disease.
This research suggests that controlling blood pressure in everyday care remains difficult, especially at stricter targets, and that people with resistant hypertension carry a heavy burden of other illnesses. Many patients also lacked suitable follow-up blood pressure measurements, which suggests room to improve monitoring and treatment adjustment in routine care. The study is observational, so it describes patterns rather than showing causes.