Pilotto L, Ambrosio G B, Zamboni S, Prattichizzo F, Cognolato E, Paruzzolo P
Minerva Med. 1983 Mar 17;74(11):557-62.
A "Community Control Programme of Hypertension" has been implemented in a Northern Italian population as part of an international co-operative pilot project promoted by World Health Organization. The programme was planned to last five years. Three years after the start we performed what we called a "capillary" screening in the community involved in the project. In fact a team of physicians and medical students moved about in the villages of the area where extemporary ambulances were set up with the aim of identifying new hypertensives, evaluating the state of the control of hypertension as compared with the situation at the outset of the study and, more generally, as a means of strengthening the ties between the project organization and the community. In doing so we also evaluated the feasibility of an alternative approach, based upon the cooperation with an organization outside the health service system, namely the Catholic Church, to achieve the set aims in a very religious population as ours. The parish priests of the villages did eagerly cooperate with our work both in the form of propaganda and in making available the parish buildings in which the ambulances were set up. We examined 1306 subjects (47.3% males), of whom 39.5% were hypertensives ("casual" blood pressure at or above 160 or 95 or treated). Of all the hypertensives, 28.6% were new hypertensives ("unaware"), 45.3% were being treated and 13.7% had a blood pressure lower than 160/95 mmHg while under treatment "effectively treated"); 16%, though, had blood pressure values at or above 200 or 120 mmHg. The state of control of hypertension was better in women and with increasing age. As compared with the findings at the outset of the study, 27,6% more "aware", 23.9% more treated and 9.6% more "effectively treated" hypertensives were found. Using the support of an alternative (non-medical) organization in a programme of preventive medicine in the community has proved to be, in our experience, a feasible, valuable and very cheap approach.
作为世界卫生组织推动的一个国际合作试点项目的一部分，意大利北部人群实施了一项“高血压社区控制项目”。该项目计划持续五年。项目启动三年后，我们在参与项目的社区进行了我们所谓的“毛细血管式”筛查。实际上，一组医生和医科学生在该地区的村庄穿梭，那里设置了临时救护车，目的是识别新的高血压患者，评估与研究开始时相比高血压的控制状况，更广泛地说，是作为加强项目组织与社区之间联系的一种方式。在此过程中，我们还评估了一种替代方法的可行性，该方法基于与卫生服务系统之外的一个组织（即天主教会）合作，以便在像我们这样宗教氛围浓厚的人群中实现既定目标。村庄的教区牧师热切地以宣传和提供设置救护车的教区建筑的形式与我们的工作合作。我们检查了1306名受试者（47.3%为男性），其中39.5%为高血压患者（“偶然”血压等于或高于160/95或正在接受治疗）。在所有高血压患者中，28.6%为新发现的高血压患者（“未意识到”），45.3%正在接受治疗，13.7%在接受治疗时血压低于160/95 mmHg（“有效治疗”）；不过，16%的患者血压值等于或高于200/120 mmHg。女性和年龄越大，高血压的控制状况越好。与研究开始时的结果相比，发现“意识到”的高血压患者多了27.6%，接受治疗的多了23.9%，“有效治疗”的多了9.6%。根据我们的经验，在社区预防医学项目中利用替代（非医疗）组织的支持已被证明是一种可行、有价值且非常廉价的方法。
