Special clinics for hypertension--the role of the hypertension detection--and follow-up programme.
The hypertension detection and follow up programme of the National Heart, Lung and Blood Institute has been briefly described, the basis given for dividing the participants into two groups, one referred to the conventional care system (referred care) and the other referred to intensive care in special clinics in which treatment was administered according to protocol in a series of graded steps in response to the therapeutic effect observed with the preceding steps (stepped care). Substantial reductions in mortality from all cardiovascular causes, including acute myocardial infarction, stroke, and other major evidences of mortality and morbidity were observed. The effect was uniform for all groups, irrespective of presence or absence of target organ damage and irrespective of race, age, and sex. Although a certain number of anomalies exist in the data, as might be expected from a study involving some 11,000 participants, the overall implication that a carefully graded and carefully developed programme of therapy confers major benefits to a population, in terms of morbidity and mortality, seems warranted. The degree to which the conventional care system can provide similar care to the hypertensive population, and experience similar benefits, represents a major challenge for the immediate future.
D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D001795:Blood Pressure Determination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000401:mortality / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration; D014481:United States