Key result
Blood pressure screening in dental care centers resulted in a hypertension diagnosis for 32.1% of patients who screened positive, requiring 18 patients to be screened to identify one new case.
Why the study?
Does blood pressure screening in dental care centers improve the detection of previously unknown hypertension in adults?
Cohort (n=1,149)
Yes
Does blood pressure screening in dental care centers improve the detection of previously unknown hypertension in adults?
Number Needed to Treat: 18
Absolute Event Rate: 32.1% vs 2.9%
Number Needed to Treat: 18
p-value: p=<0.0001
Blood pressure screening in dental care settings is an effective strategy for identifying previously undiagnosed hypertension, requiring 18 screenings to detect one new case.
Supports opportunistic dental clinic screening to reduce undiagnosed hypertension; leaves open whether this strategy.
BACKGROUND: There is consensus on the importance of early detection and treatment of high blood pressure. Dental care is one of few medical services to which a considerable proportion of the general population comes for regular check-ups. We tested the effects of blood pressure screening in dental care centres with subsequent work-up of subjects screening positive in primary health care (PHCC). METHODS: Altogether 1,149 subjects 40-65 years old or 20-39 years old with body mass index >25, and with no previously known hypertension, who came for a dental examination had their blood pressure measured with an Omron M4® automatic blood pressure reading device. Subjects with systolic blood pressure readings above 160 mmHg or diastolic above 90 mmHg were referred to their PHCC for a check up. Outcome data were obtained by scrutiny of PHCC and hospital patient records for hypertension diagnoses during the three years following screening. RESULTS: 237 (20.6%) subjects screened positive. Of these, 230 (97.1%) came to their PHCC within the 3-year follow-up period, as compared with 695 (76.2%) of those who screened negative (p < 0.0001). Of those who screened positive, 76 (32.1%) received a diagnosis of hypertension, as compared with 26 (2.9%) of those who screened negative. Sensitivity was 79.1%, specificity 84.8% and positive predictive value 30.1%. The number of subjects needed to screen to find one case of hypertension was 18. CONCLUSIONS: Co-operation between dental and primary care for blood pressure screening and work-up appears to be an effective way of detecting previously unknown hypertension.
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Engström et al. (2011) conducted a cohort in Hypertension (n=1,149). Blood pressure screening vs. Screened negative was evaluated on Diagnosis of hypertension within 3 years (NNS 18, p=<0.0001). Blood pressure screening in dental care centers resulted in a hypertension diagnosis for 32.1% of patients who screened positive, requiring 18 patients to be screened to identify one new case.
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