Document Detail


Screening for hypertension among older adults: a primary care "high risk" approach.
MedLine Citation:
PMID:  20606923     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Recommendations for early detection and management of elevated blood pressure through opportunistic clinic-based screening may be inadequate for the rural population in India as access to health facilities is limited.
MATERIALS AND METHODS: Sixteen Health Aides (trained primary care workers) were trained to measure blood pressure using a standardized training procedure. Six of those assessed competent in initial evaluation were allotted a stratified random sample of about 150 persons each, 50 years or over, in the village under their care to measure blood pressures during their regular scheduled visits.
RESULTS: 14/16 of the health aides (83%) met the stipulated criteria for the simulation study using a module from British Hypertension Society. In the field survey of 920 individuals where 20% of the population was evaluated by a blinded investigator, the weighted Kappa for agreement, using normal, pre-hypertension and hypertension as categories, ranged between 62% and 89%. Only 75/286 (25%) of those detected to be hypertensive knew their status prior to the study. All those detected with hypertension were referred to a physician at a referral facility. 70% of those referred were evaluated at the referral facility and 64% of them initiated on treatment for hypertension within 3 months.
CONCLUSION: Using primary care workers to screen for hypertension through the model suggested here will ensure that the population over 50 years of age will be screened once every 2 years without burdening the worker. This screening process will enable the health system to identify and cater to needs of this vulnerable population.
Authors:
Jacob John; Jayaprakash Muliyil; Vinohar Balraj
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine     Volume:  35     ISSN:  1998-3581     ISO Abbreviation:  Indian J Community Med     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-07-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9315574     Medline TA:  Indian J Community Med     Country:  India    
Other Details:
Languages:  eng     Pagination:  67-9     Citation Subset:  -    
Affiliation:
Department of Community Health, Christian Medical College, Vellore - 632 002, India.
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