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Hypertension is highly prevalent and remains poorly controlled. The purpose of this study was to evaluate blood pressure (BP) control in patients with uncontrolled hypertension 1 year after referral to a hypertension specialist. A retrospective chart review was performed on 158 patients evaluated by a single hypertension specialist between 2005 and 2010 at the Penn Hypertension Program. Patients were included if they had at least 1 year of follow-up and had baseline plasma renin activity and plasma aldosterone concentration measured. Drug regimens were adjusted with particular attention to results of renin-aldosterone profiling. Mean BP of the entire cohort decreased from 149/87 mm Hg to 129/78 mm Hg at 1 year (P<.0001), without a significant change in the number of antihypertensive medications. The authors observed that referral to a hypertension specialist was worthwhile and associated with a significant reduction in BP without an increase in the number of BP medications used at 1 year.