A study from England reviewed the management of hypertension in England and the US. It found that in America, the wealthier are more likely to manage their high blood pressure effectively. By contrast, those in a lower socio-economic class tend to manage the condition poorly. The study found that in England, management was relatively equal among socio-economic groups. The authors attribute this to low cost of care for patients and a stronger primary care system, which they say the US lacks. Given the significant role that hypertension plays in disease, management is crucial.