Clinical program for screening and treatment of hypertension in veterans.

Hypertension clinics, in which primary care is provided by specially trained nonphysician therapists under physician supervision, can provide very effective and relatively inexpensive control of hypertension for large numbers of patients. Since 1972, 32 VA Hypertension Screening and Treatment Clinics have screened about 500,000 veterans, 29 percent of whom have had diastolic pressures of 90 mmHg or more and 13 percent of whom have had diastolic pressures of 105 mmHg or more. Of subjects who returned for a second visit, 77 percent continued to have diastolic pressures of 90 mmHg or more. Blacks had a higher percentage of severe hypertension than whites.Since treatment became available in these clinics in 1974, 25,000 veterans have been treated. Computerized data are available for 10,777 of them who began treatment during 1974, 1975, or 1976. Of those with at least five treatment visits during that period, half had diastolic pressures below 90 mmHg at their most recent visit, and 80 percent had diastolic pressures below 100 mmHg. Moreover visit adherence was high, with two thirds of those who began treatment in these clinics during their first six months of operation continuing that treatment for two and a half years.