[Public hypertension screening and problems of individual long term control]

Four months after public screening for hypertension during the Swiss Trade Fair 1974, a random sample of 302 hypertensives referred to private practitioners were interviewed to determine the impact of the screening on longterm control through private practice. 201 hypertensives went for further blood pressure control: the previously aware did so more frequently than the previously unaware (p less than 0.01). 112 of 201 were confirmed as hypertensives by private practitioners: this occurred in 80% of aware but in only 36% of unaware patients. 94 were started on therapy. 76 of 112 (2/3) received further appointments. Another 101 hypertensives did not seek care. Main determinants were insufficient knowledge about hypertensive disease and a shorter period of formal education; half of them claimed "they felt perfectly well". In summary one third did not seek care, another third were not confirmed as hypertensive or were lost to follow-up, and only one third (50% of the aware and 10% of the unaware) were still under regular care. While community-wide screening provided an opportunity for educational compaigns and positively affected the behaviour of hypertensives who were already aware, the yield in terms of newly identified hypertensives still under control 4 months later was extremely low. Before further developing community screening programs, feasibility studies must define mechanism for improved longterm control.