Epidemiology and treatment of hypertension in the community

Abstract

During 1974 to 1976 an epidemiological survey carried out in Paisley, Scotland, in 12,466 men and women aged between 45 and 64 years showed that about 5 % had raised blood pressure of 110 mmHg or more diastolic, and about 10% had mild to moderate hypertension (90 to 109 mmHg diastolic). Results after 30 months showed a satisfactory reduction in systolic and diastolic blood pressures inpatients who were treated compared with a control group. The cumulative percentage lapse rate in those treated over 24 to 30 months in the Paisley group was 14.35%. Preliminary findings suggest that the greatest benefit to the community would derive from treatment of the larger number of mild to moderate hypertensives than of the relatively small number of more severely affected patients. For such treatment, the need is for an effective, single daily dose antihypertensive agent with minimum side-effects, e.g. indapamide. It is suggested that an economic and more satisfactory alternative to mounting large-scale mass health examination surveys is for the systematic identification and treatment of raised blood pressure to be carried out in general practice as part of good primary medical care. A 3-year pilot study is being conducted to test the feasibility of such a scheme.