Problems with hypertension detection in family practice.

The family physician's office is the preferred site for case-detection of hypertension. However, certain problems interfere with case-detection efforts. There have been conflicting messages about the levels of blood pressure needed to diagnose hypertension and institute therapy. Given the natural history of hypertension, an appropriate goal would be a blood pressure measurement on every patient every two years. The problem-solving approach to patients is another factor which interferes with case-detection. Certain office organization factors are relevant. Blood pressure measurements taken in the office may not fairly represent true 'blood' pressure; a case can be made for increased use of home blood pressures. Finally, care must be taken in the techniques of blood pressure measurement.