Antihypertensive drug treatment in a middle-aged population

In Finland's North Karelia region a community-based program for control of hypertension was administered for 5 years. Afterward, drug treatment and the impact of such treatment on control of blood pressure were studied in a cross-sectional survey. The study population (n = 10,199) consisted of a 6.6% random sample of people aged 30-64 years in North Karelia (program area) and Kuopio (reference area). Rate of participation was about 90%. The methods included questionnaire, personal interview, and clinical examination. In North Karelia, 24% of the men and 25% of the women were hypertensives (blood pressure greater than or equal to 175 mm Hg systolic and/or 100 mm Hg diastolic, or currently on antihypertensive drug therapy), compared with 33% of the men and 29% of the women in the reference area. In North Karelia, 48% of the male hypertensives and 67% of the female hypertensives were on drug therapy, compared with 32% and 54%, respectively, in the reference area. Of the total population in each area, 14% in North Karelia currently used drugs, compared with 13% in the reference area. Diuretics and beta-blockers were the drugs most commonly prescribed; men used beta-blockers more often than women did. In terms of quantity of medication, type of drugs, and compliance, the differences between the two areas were small. Control of blood pressure, however, was clearly better in North Karelia than in the reference area for hypertensives and drug users and for both men and women. Therefore, compared with the traditional system, organized hypertension care results in more successful treatment.