Management of hypertension newly detected by health screening.

An attempt was made, through a hospital-based health screening service, to ensure proper longterm care of clients with hypertension and other cardiovascular risk factors. Of 8755 subjects screened on one occasion, 1274 (14.6%) had a blood pressure reading above defined limits; of these, 1058 were not receiving antihypertensive drugs. Apparently hypertensive subjects were rescreened within one week or were referred to their local doctors. At their second visits, over half of the 716 rescreened subjects had reading consistently below the defined limits. Those with intermittent blood pressure elevation (89 patients) were designated as having labile hypertension, and were reviewed regularly. The remainder, with persisting hypertension, were sent to their local doctors or to the hospital's hypertension clinic. After six months, the group ith labile hypertension showed no change in mean left cardiac ventricular voltage, and more than 50% the group had normal blood pressure; 14 patients were receiving antihypertensive drugs. Subjects referred to the hypertension clinic had a high prevalence of cardiovascular risk factors and a low prevalence of clinically evident organ damage. Only half of this group were deemed to require drug therapy. In a postal survey of clients referred to private doctors, 35% of respondents reported that they had started taking anti-hypertensive drugs. Thorough rescreening of blood pressure is essential in preventing the unnecessary use of antihypertensive drugs, and this can be facilitated by providing management streams appropriate to the needs of the individual subject.