HYPERTENSION CONTROL AMONG PATIENTS REFERRED BY A COMMUNITY BLOOD-PRESSURE SCREENING-PROGRAM

Since 1974 the Milwaukee Blood Pressure Program (MBP) has screened more than 175,000 people for hypertension, 4672 newly identified hypertensives have been referred for treatment to practicing physicians and to a medical school affiliated hypertension clinic on the basis of two elevated blood pressure readings. The mean duration of follow-up has been 20 months for private patients and 14 months for clinic patients. Ninety-two per cent of the referred patients, were subsequently confirmed to have an elevated blood pressure. Approximately 90% of the confirmed hypertensive patients received antihypertensive drugs. Seventy-three per cent of the private patients and 97% of the clinic patients received a diuretic. The antihypertensive drugs were stopped on few occasions by the physician. Lifestyle changes in terms of weight loss and reduction in smoking and drinking were attempted in the clinic. Whereas heavy smoking and alcohol intake could be reduced in some patients, little change in weight was generally observed. Hypertension was controlled in 65% of the private patients and 84% of the clinic patients. The better clinic results may reflect more frequent use of combination antihypertensive therapy and use of the nurse clinicians for reinforcement of the physician's advice in the clinic setting. © 1979.