Screening for hypertension: some practical problems.

In 1967/68, a screening examination was carried out on 18,277 male London civil servants, of whom 488 were referred to their general practitioners with high blood pressure. After this referral, 23 per cent did not attend their doctor and among those who did, a relatively high frequency of anxiety was noted. In one third of the patients, the general practitioners were already aware of the presence of hypertension, but were not treating it. This reluctance to treat asymptomatic people continued with the management of referred and confirmed newly diagnosed hypertensive patients. The problems associated with mass screening examinations can be overcome by careful, expensive and time-consuming preparations. Where the purpose is to find and treat newly diagnosed hypertensive patients then screening by general practitioners is likely to be a more cost-effective approach.