News from the American Heart Association

Experience since the first ICHI) report on hypertension was published has led to a deemphasis of the need for a stratif'ied system with special hypertensioui treatment centers dedicated to the care of hypertensive patients because the present system with suitable modifications has proved adequate except for some medically underserved groups. The need for large scale community detection programs has diminished as an increasing percentage of the hypertensive population has been identified. Screening programs should be targeted to the hard-toreach segments of the population (e.g., males under age 50), and provision should be made to assure that high blood pressure subjects are appropriately referred for evaluation and management. Since 80% of the American people come into contact with the health care system every year, emphasis should be placed on having providers measure blood pressure at every encounter, assume responsibility for informing the individual if blood pressure is elevated, and make appropriate referrals for confirmation and follow-up. Epidemiologic studies since the first ICHD report offer reasonable hope that primary prevention of hypertension will ultimately be possible. The Hypertension Detection and Follow-up Program (HDFP) has provided evidence that systematic treatment of mild hypertension (diastolic 90 to 104 mm Hg) will reduce cardiovascular mortality, and this fact must be communicated to physicians and to the public. The success of the National High Blood Pressure Education Program and the American Heart Association in focusing community resources on the identification and control of hypertensive persons in the United States should not deter ongoing research efforts to identify the cause or causes for primary hypertension so that ultimately prevention or cure will be possible. Nor should the present emphasis on economy in government be permitted to diminish the federal and state participation in hypertension control activities which has been so crucial to the success of this effort.

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