title: Efficacy of screening for high blood pressure in dental health care.
abstract: BACKGROUND
  There is consensus on the importance of early detection and treatment of high blood pressure. Dental care is one of few medical services to which a considerable proportion of the general population comes for regular check-ups. We tested the effects of blood pressure screening in dental care centres with subsequent work-up of subjects screening positive in primary health care (PHCC).
  
  
  METHODS
  Altogether 1,149 subjects 40-65 years old or 20-39 years old with body mass index >25, and with no previously known hypertension, who came for a dental examination had their blood pressure measured with an Omron M4® automatic blood pressure reading device. Subjects with systolic blood pressure readings above 160 mmHg or diastolic above 90 mmHg were referred to their PHCC for a check up. Outcome data were obtained by scrutiny of PHCC and hospital patient records for hypertension diagnoses during the three years following screening.
  
  
  RESULTS
  237 (20.6%) subjects screened positive. Of these, 230 (97.1%) came to their PHCC within the 3-year follow-up period, as compared with 695 (76.2%) of those who screened negative (p < 0.0001). Of those who screened positive, 76 (32.1%) received a diagnosis of hypertension, as compared with 26 (2.9%) of those who screened negative. Sensitivity was 79.1%, specificity 84.8% and positive predictive value 30.1%. The number of subjects needed to screen to find one case of hypertension was 18.
  
  
  CONCLUSIONS
  Co-operation between dental and primary care for blood pressure screening and work-up appears to be an effective way of detecting previously unknown hypertension.
authors: Uppsala University, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology Section, Uppsala, Sweden. sevek.engstrom@pubcare.uu.se
authors: Sevek
authors: S
authors: Engström
authors: Christian
authors: C
authors: Berne
authors: Lars
authors: L
authors: Gahnberg
authors: Kurt
authors: K
authors: Svärdsudd
mesh_terms: D000328:Adult; D000368:Aged; D003299:Cooperative Behavior; D003729:Dental Care / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D055815:Young Adult