ESTIMATED COMMUNITY IMPACT OF HYPERTENSION CONTROL IN A HIGH RISK POPULATION

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Abstract
Relative risks for cerebrovascular disease obtained from the Evans County, Georgia, population were applied to the hypertensive population In a black urban community screened for hypertension in Baltimore, Maryland. Fortytwo per cent of the screened population were found to be hypertensive. The population attributable risk statistic as defined by Levin was calculated from the relative risks in order to estimate the expected impact of hypertension on the development of stroke in the community before Intervention. It was found that 56 per cent of strokes In black males and 46 per cent in black females could be attributed to hypertension in the Baltimore population. But of the hypertensives identified at home, only 52 per cent accepted a clinic visit, received treatment and persisted on treatment for at least one visit beyond initial therapy. Taking this attrition into consideration, of the strokes attributed to hypertension, only 31.6 percent in males and 29.3 per cent In females could be eliminated by hypertension treatment. However, 10 per cent of the strokes in males and 15 per cent In females would already have been affected by the private medical sector, leaving only 22 per cent of strokes in males and 14 per cent in females to be eliminated through a community screening and treatment program. To make community screening programs more effective in reducing the number of strokes in a community through hypertension treatment, a built-in surveillance and follow-up program for converters and refusals considered to be at a possible higher risk is suggested. Methods to ensure prompt identification, treatment and compliance should also be Incorporated Into these community programs.

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