Hypertension screening and treating in a tuberculosis clinic

AB~TRA~IX:

HIGH

77

BLOOD PRESSURE CONTROL

A-89 COMPLIANCE WITH RECOMMENDATIONSOF THE JOINT NATIONAL COMMITTEE ON DETECTION, EVALUATION AND TREATMENT OF HIGH BLOOD PRESSURE: FINDINGS OF A NATIONAL PROBABILIiY SAMPLE SURVEY PHYSICIAN

Robert Robert

A. Gold, Temple;

National High Blood Pressure Graham W, Ward; Reuben Cohen;

Education Program, Deanne E. Knapp

Bethesda,

Maryland,

Despite recent encouraging data both provider and patient compliance remain far In January 1977 the Joint National Conrmittee on Detection, below optimal levels. Evaluation and Therapy of High Blood Pressure issued updated guidelines for provider compliance. Nine months later, the Food and Drug Administration, in cooperation with the National High Blood Pressure Education Program, conducted a national survey of physicians to determine their information base, attitudes and reported behavior toward hypertension. The survey was designed to provide NHBPEP with current information on how physicians perceive hypertension, their diagnostic and treatment criteria, and their long term management approaches and goals. Survey design consisted of a national probability sample of the total universe of 110,000 U.S. physicians actively practicing in general/family practice, internal medicine, and cardiology. Probability samples were constructed for each specialty and subsamples for the age ranges of under 35, 35-50 and over 50. Survey procedures consisted of an initial questionnaire mailed to 6,400 physicians comprising the nation1 probability sample and two additional mailings to initial nonrespondents. In addition a special personal contact of a subsample of 25% of nonrespondents was instituted to achieve a weighted response rate of 75%. Frequency counts and cross tabulations of responses were compared to recommended guidelines, and analyzed by Analysis revealed conspecialty, age, and type and size of practice/patient load. siderable variation in responses to key diagnosis and treatment questions, and indicated significant areas of compliance and noncompliance with recommended guidelines. Findings of the study highlight important medical education needs and provide a sound basis for future program development. A-90 HYPERTENSION A. David Western

SCREENING

Goldberg, Reserve

AND

Cleveland University,

TREATING

IN

Metropolitan Cleveland,

A TUBERCULOSIS

Ohio;

General Frits

CLINIC Hospital van der

and Kuyp

Case

A study was undertaken to determine whether the public health approach that has successfully led to the near-elimination of tuberculosis from the inner city of Cleveland could be used for the detection and control of hypertension. A hypertension screening and treating clinic was incorporated into one of the county T.B. clinics and all persons entering were offered blood pressure measurements and follow-up treatment as necessary. In the first six months blood pressures were recorded sons. Of these, 648 (17%) were considered high ()160/95 516 (14%) borderline ()140/90), and were recommended blood pressure measurements. In this group 579 (50%) their blood pressure was elevated, but only 327 (28%) medication. In the total sampled population 428 (11.5%) ing medication for hypertension and the pressures were (<140/90 mmHg) in 72 (17%); borderline (<160/95 mmHg) and uncontrolled (>160/95 mmHg) in 248 (58%). After further evaluation, this dedicated clinic. attending regularly and Thus, a dedicated hypertension in

the

clinic inner

154 hypertensives elected Using a simple therapeutic are now well controlled. approach city

can community.

successfully

on

3,736 permmHg) and for further were aware that were receiving were receivcontrolled in 102 (24%)

to be regime

treated 129 are

detect

and

control

in