Does labelling and treatment for hypertension increase illness behaviour?

This study looked at the possible harmful effects of detection and treatment for hypertension. Patients with borderline blood pressure (diastolic 96-109 mmHg) were randomized into two groups: an intervention group receiving treatment for hypertension and a control group not told about any problem and left untreated. The morbidity in these two groups were studied for differences. During the period studied, the patients in the investigation group saw the doctor more frequently and had a larger number of diseases classified than the control group. When consultations involving hypertension and its follow up were excluded, however, no differences were demonstrable between the groups. Problem behaviour, psychosomatic and functional affections and symptom diagnoses were evenly distributed over the two groups. The difference in blood pressure between the two groups after completion of the study was not marked: the decrease in diastolic blood pressure averaged 7.6 mmHg in the control group versus 9.1 mmHg in the intervention group. In cases where the initial blood pressure values are only slightly raised, careful monitoring of blood pressure over a long period seems to be as effective as treatment for hypertension. The general practitioner should focus especially on anticipation in this sense.