Skip to main content
NCBI home page
The BMJ logoLink to The BMJ
. 1991 Jan 26;302(6770):219–222. doi: 10.1136/bmj.302.6770.219

Detecting hypertension: screening versus case finding in Norway.

J Holmen 1, L Forsén 1, P F Hjort 1, K Midthjell 1, H T Waaler 1, A Bjørndal 1
PMCID: PMC1669080  PMID: 1998765

Abstract

OBJECTIVE--Evaluation of detection of hypertension in adults in the county of Nord-Trøndelag, Norway. DESIGN--Cross sectional survey with clinical follow up examinations. SETTING--Health survey by screening teams from the national health screening service, and examinations by all 106 general practitioners in the county. SUBJECTS--During 1984-6, 74,977 persons (88.1% of those aged 20 years and over) participated in the health survey. MAIN OUTCOME MEASURES--Hypertension (when assessed by standardised recording and by questionnaires on drug treatment for hypertension) according to the blood pressure thresholds used in the Norwegian treatment programme. Subjects positive on screening were grouped after clinical examination into treatment groups. RESULTS--In all, 2399 subjects were positive for hypertension. Before screening 6210 (8.3%) patients reported taking antihypertensive drugs and another 3849 (5.1%) had their blood pressure monitored regularly. All who screened positive were referred to their general practitioner and evaluated according to a standard programme. As a result, drug treatment was started in 406 (0.5%) participants screened and blood pressure monitoring in another 1007 (1.3%). Of all patients taking antihypertensive drugs after the screening, 6399 (94.0%) had been diagnosed before screening, and of those whose blood pressure was monitored after the screening, 79.3% had been diagnosed before screening. CONCLUSIONS--At the blood pressure screening thresholds used, and when hypertension is defined by an overall clinical diagnosis, the results indicate that general practitioners can find and diagnose hypertensive patients with the case finding strategy.

Full text

PDF
219

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aromaa A., Pyörälä K. Finländskt vårdprogram för arteriell hypertension. Nord Med. 1979 Sep;94(8-9):204–208. [PubMed] [Google Scholar]
  2. Berglund G., Isacsson S. O., Rydén L. Modell för omhändertagande av patienter med högt blodtryck. Lakartidningen. 1978 Nov 15;75(46):4253–4256. [PubMed] [Google Scholar]
  3. Berglund G., Wilhelmsen L., Werkö L. Blood pressure development and characteristics of subjects with moderate blood pressure elevation. A two-year follow-up study in a random population sample. Acta Med Scand. 1974 Oct;196(4):301–306. doi: 10.1111/j.0954-6820.1974.tb01015.x. [DOI] [PubMed] [Google Scholar]
  4. Dannenberg A. L., Garrison R. J., Kannel W. B. Incidence of hypertension in the Framingham Study. Am J Public Health. 1988 Jun;78(6):676–679. doi: 10.2105/ajph.78.6.676. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Eilertsen E., Humerfelt S. The blood pressure in a representative population sample. Acta Med Scand. 1968 Apr;183(4):293–305. doi: 10.1111/j.0954-6820.1968.tb10481.x. [DOI] [PubMed] [Google Scholar]
  6. Hines E., Powell C. E., Metts J. C., Jr, Grimes V., Satcher D. Regional and local high blood pressure control programs. J Med Assoc Ga. 1981 May;70(5):353–355. [PubMed] [Google Scholar]
  7. Krishan I., Davis C. S., Nobrega F. T., Smoldt R. K. The Mayo three-community hypertension control program. IV. Five-year outcomes of intervention in entire communities. Mayo Clin Proc. 1981 Jan;56(1):3–10. [PubMed] [Google Scholar]
  8. Labarthe D. R., Krishan I., Nobrega F. T., Brennan L. A., Jr, Smoldt R. K., Mori H. D., Hunt J. C. The Mayo Three-Community Hypertension Control Program. I. Design and initial screening results. Mayo Clin Proc. 1979 May;54(5):289–298. [PubMed] [Google Scholar]
  9. Nissinen A., Tuomilehto J., Puska P. Management of hypertension and changes in blood pressure level in patients included in the hypertension register of the North Karelia Project. Scand J Soc Med. 1980;8(1):17–23. doi: 10.1177/140349488000800103. [DOI] [PubMed] [Google Scholar]
  10. Råstam L., Berglund G., Isacsson S. O., Rydén L. The Skaraborg hypertension project. II. Feasibility of a medical care program for hypertension. Acta Med Scand. 1986;219(3):249–260. [PubMed] [Google Scholar]
  11. Sigurdsson J. A., Bengtsson C. Prevalence and management of arterial hypertension in a population sample of Swedish women. Scand J Soc Med. 1981;9(1):41–47. doi: 10.1177/140349488100900106. [DOI] [PubMed] [Google Scholar]
  12. Smith W. C., Lee A. J., Crombie I. K., Tunstall-Pedoe H. Control of blood pressure in Scotland: the rule of halves. BMJ. 1990 Apr 14;300(6730):981–983. doi: 10.1136/bmj.300.6730.981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Stamler J., Stamler R., Riedlinger W. F., Algera G., Roberts R. H. Hypertension screening of 1 million Americans. Community Hypertension Evaluation Clinic (CHEC) program, 1973 through 1975. JAMA. 1976 May 24;235(21):2299–2306. doi: 10.1001/jama.235.21.2299. [DOI] [PubMed] [Google Scholar]
  14. Stamler R., Stamler J., Gosch F. C., Civinelli J., Fishman J., McKeever P., McDonald A., Dyer A. R. Primary prevention of hypertension by nutritional-hygienic means. Final report of a randomized, controlled trial. JAMA. 1989 Oct 6;262(13):1801–1807. [PubMed] [Google Scholar]
  15. Tuomilehto J., Puska P., Virtamo J., Nissinen A. Hypertension control in North Karelia before the intervention of the North Karelia Project. Scand J Soc Med. 1980;8(1):9–15. doi: 10.1177/140349488000800102. [DOI] [PubMed] [Google Scholar]
  16. Wilber J. A., Barrow J. G. Hypertension--a community problem. Am J Med. 1972 May;52(5):653–663. doi: 10.1016/0002-9343(72)90055-1. [DOI] [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES