Hindawi Publishing Corporation International Journal of Hypertension Volume 2012, Article ID 405892, 8 pages doi:10.1155/2012/405892 Research Article Overcoming Barriers in the Management of Hypertension: The Experience of the Cardiovascular Health Program in Chilean Primary Health Care Centers Daniela Sandoval, 1 Miguel Bravo, 2 Elard Koch, 1, 2 Sebasti´ an Gatica, 2 Ivonne Ahlers, 1 Oscar Henr´ ıquez, 1 and Tom´ as Romero 3, 4 1 Department of Family Medicine & Primary Care, Faculty of Medicine, University of Chile, 8380453 Santiago, Chile 2 Institute of Molecular Epidemiology (MELISA), Faculty of Medicine, Universidad Cat´ olica de la Sant´ ısima Concepci´ on, 4070129 Concepci´ on, Chile 3 School of Medicine, University of California, San Diego, CA 92093, USA 4 Fundacion Araucaria Foundation, Coronado, CA 92118, USA Correspondence should be addressed to Daniela Sandoval, dsandovalh@gmail.com Received 7 January 2012; Accepted 7 February 2012 Academic Editor: Kazuko Masuo Copyright © 2012 Daniela Sandoval et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To assess the blood pressure control and cardiovascular risk factors (CVRFs) in a population of hypertensive patients with access to care under a government-financed program, the Cardiovascular Health Program (CHP). Design. A cross-sectional and multicenter study. Setting. 52 primary care centers, metropolitan area of Santiago, Chile. Participants. 1,194 patients were selected by a systematic random sampling from a universe of 316,654 hypertensive patients. Key Measurements. Demographic information, blood pressure (BP) measurements, and CVRF were extracted from medical records of patients followed for a 12- month period. Results. 59.7% of patients reached target BP < 140/90 mmHg. More women were captured in the sampling (2.1 : 1), achieving better BP control than men. Diabetic patients (26.4%) had worse BP control than nondiabetics. Antihypertensive medications were used in 91.5%, with multidrug therapy more frequent in patients with higher BP and more difficult control. Conclusions. The success in improving the BP control to values <140/90 mmHg from 45.3% to 59.7% underscores the contribution of this program in the Chilean primary care cardiovascular preventive strategies. However, fewer hypertensive men than women were captured by this program, and it is of concern the underperforming of BP control observed in diabetics. 1. Introduction Hypertension control has been instrumental to achieve a sig- nificant reduction in cardiovascular events. However, despite the advancements in antihypertensive drug therapy, success in controlling BP to the Joint National Committee VII guide- lines (BP < 140/90 mmHg) has been quite disappointing. Most of the published information has reported satisfactory BP control in only 30% to 45% of the hypertensive popula- tion [1–5]. Numerous factors have been mentioned as responsible for this limited results including socioeconomic status, barriers in the access to health care, lack of a population- oriented program focused on preventive cardiovascular mea- sures, poor adherence, among others [1, 6–8]. The Chilean Ministry of Health started a Cardiovascular Health Pro- gram (CHP) (Programa de Salud Cardiovascular, PSCV) in 2002 with the objective of reducing the cardiovascular morbidity and mortality by a global management strategy of cardiovascular risk factors (CVRF) in patients followed at the primary care level [9, 10]. Approximately 76.9% of the Chilean population is enrolled in a primary care clinic through the public health system. This is financed by the Ministry of Health through subsidies to the primary care