Abstract
Trends in antihypertensive treatment and stroke mortality were analysed in the province of North Karelia where the first systematic hypertension control programme in Finland was started in 1972. Surveys carried out in random samples of the middle-aged population of North Karelia showed that the control of hypertension was better than in the reference area, especially from 1972 to 1977. From 1972 to 1984, mortality from stroke fell on average 6.3% and 7.6% per annum, in North Karelian men and women aged 35-64 years. These declines were steeper than those observed in the rest of Finland. In the age group of 65-74 years the decline in stroke mortality was also steeper in North Karelia. From 1978 to 1984 the self-reported awareness of hypertension and the proportion of people receiving antihypertensive drug treatment decreased in the middle-aged population in Finland, suggesting lesser efforts at detection and treatment. During the same period, the steep national decline in stroke mortality levelled off, but the mortality rate remained higher than in the USA and in other Western European countries. Prevention of stroke through hypertension control in the community still remains a major challenge for health care.