May 24, 1976
View Full PaperHypertension Screening of 1 Million Americans
Structured PICO
What is the prevalence and treatment status of elevated blood pressure among Americans screened in a nationwide program?
P
Population
More than 1 million persons screened in the nationwide Community Hypertension Evaluation Clinic (CHEC) program in the United States.
I
Intervention
Blood pressure screening via the Community Hypertension Evaluation Clinic (CHEC) program
O
Outcome
Prevalence of elevated blood pressure (diastolic reading ≥90 mm Hg or ≥95 mm Hg) and rates of undetected, untreated, and uncontrolled hypertension
This large-scale 1970s screening program highlighted a massive public health gap, showing that over half of hypertensive Americans were undiagnosed, untreated, or inadequately managed.
Abstract
During 1973 through 1975, more than 1 million persons were screened in the nationwide Community Hypertension Evaluation Clinic (CHEC) program at 1,171 sites. While those screened were not from defined populations, findings paralleled those of recent surveys of US population samples. First, CHEC confirmed the scope of the problem of elevated blood pressure in the United States. Of those screened, 247 of 1,000 had a diastolic reading of 90 mm Hg or higher; 116 of 1,000 had a reading of 95 mm Hg or greater. Prevalence of elevated blood pressure rose with age up to age 50 years, was higher in blacks than in whites, and was higher in men than in women. Second, CHEC data confirmed the challenge of undetected, untreated, and uncontrolled hypertension. Previously undetected hypertension was present in 27.7% of hypertensive people, detected but untreated in 10.7%, and treated but uncontrolled in 16.7%--totaling 55.1%.