The role of health care practitioners in the detection and control of hypertension.
It is well established that pharmacologic treatment of sustained diastolic blood pressure elevation can reduce the risk of subsequent cardiovascular morbidity and mortality. One problem confronting health care workers is to ensure that the maximum number of people who would benefit from antihypertensive treatment actually are brought under treatment and good control. Because hypertension is asymptomatic, it has been suggested that routine blood pressure measurement by a wide variety of health care practitioners would help to increase coverage. A community blood pressure survey was done to estimate detection and control rates. Information also was collected on recency of attendance to seven categories of health care practitioners. Nearly 90% of the population had seen a physician within the previous two years. Although nearly all subjects had visited a dentist, only 75% had visited within the last two years. For the other categories, population coverage was much lower. There was no evidence that undetected or untreated hypertensive persons were more likely to be seen by nonphysicians. These results do not identify a role for nonphysicians in hypertension detection or monitoring. Rather, routine blood pressure measurement on all patients by physicians should be adequate to ensure high detection and treatment rates.
Birkett
N J
NJ
Department of Epidemiology and Community Medicine, University of Ottawa, Ontario, Canada.
D000328:Adult; D000368:Aged; D001795:Blood Pressure Determination; D003815:Dentists / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D009864:Ontario; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010821:Physicians, Family / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires