Appropriateness of referral to a European society of hypertension center of excellence

In agreement with previous reports,6–8 our study defines a significantly high proportion of referrals as inappropriate and not matching guidelines’ criteria for referral. This suggests that many primary care physicians choose to refer patients with uncomplicated hypertension to a hypertension specialist, rather than undertaking or maintaining the management of the patient. This trend seems to have paradoxically increased since the introduction of the Hypertension Specialist and the indications for referral in the JNC 7 guidelines, thus suggesting that the general practioner is either unaware of or ignores the guidelines.