Abstract
The quality of care of three groups of known hypertensives was compared. The groups were (1) subjects who have never used antihypertensive drugs; (2) those who have used drugs occasionally; (3) those who use them currently. Comparison is made between two areas: North Karelia, where there is an active community programme for control of hypertension, and the control area, where the regular health care system existed. The study material comprised a random sample of people aged 30–64 years in 1977.
The results showed that whilst availability of treatment was equal between the areas there was better utilization of the health care system and better results of the treatment in every subgroup in North Karelia. The number of blood pressure measurements was higher in the control area, but the frequency of consultation with physicians did not differ between the two areas.
Systolic and diastolic blood pressures in each treatment group were higher in the control area than in North Karelia. Among currently treated hypertensives this difference averaged 4 mm of mercury in men for systolic pressure and 5 mm in diastolic pressure. For women the equivalent figures were 6 mm of mercury for systolic and 6 mm diastolic blood pressure. Among those who had previously used hypertensive drugs the difference was 7 mm of mercury in men for diastolic and 8 mm for systolic. In women the differences in diastolic and systolic pressure were 3 mm in each case. Also the percentage of those with casual diastolic blood pressures over 105 mm of mercury was clearly greater in the control area than in North Karelia.
We conclude that the better results among hypertensives that were observed in all three subgroups are due to the known programme of care for hypertension in the North Karelia community, which consists of several components. These included early detection, rational antihypertensive drug therapy and intensive health education of persons with elevated blood pressure values.