DALLAS, Texas, Aug. 7, 1998 -- Aggressive, broad-based programs offering health screenings and education programs to help people lower high blood pressure show dramatically better results than more laissez-faire programs developed to achieve the same goal, scientists say.
In a study in this month's Stroke: Journal of the American Heart Association, Japanese researchers say that not all public health programs are created equal. They found that a more intense, community-integrated program helped people much more than a minimally-integrated program. Men exposed to the more aggressive programs did a better job of controlling their blood pressure and, in turn, had fewer strokes.
Researchers compared the effectiveness of high blood pressure control programs on 4,687 people in two rural towns in northeastern Japan. The full intervention program included high blood pressure education classes, blood pressure screenings, referrals of high-risk individuals for high blood pressure medication, use of media to encourage participation in blood pressure screenings and a campaign to reduce salt intake. Strategies of the minimal intervention program were similar, but did not include adult classes or media education.
The aggressive program featured announcements transmitted via speakers attached to each household telephone. The announcements recruited participants to blood pressure screenings and adult classes. Individuals could turn the speaker off. More than 80 percent of people between the ages of 40 to 69 years were screened in both communities in the 1960s. Researchers found significant declines in stroke incidence in men in the full intervention community when compared to the 1960s. There was a 42 percent reduction in stroke incidence between the 1960s and the period from 1970 to 1975, a 53 percent reduction when incidence was measured between 1976 and 1981 and a 75 percent decrease when comparing stroke incidence from 1982 and 1987.
In the minimal intervention community, there was actually an increase (5 percent) in stroke incidence between 1970 and 1975, a 20 percent decrease between 1976 and 1981 and a 29 percent decrease between 1982 and 1987.
The researchers, led by the study's lead author Hiroyasu Iso, M.D., of the Institute of Community Medicine, University of Tsukuba, Japan, found that systolic blood pressure in men declined more in the full-intervention community than in the minimal-intervention community. Iso says this supports the idea that screenings for high blood pressure are an important step in stroke reduction.
NR 98-4934 (Stroke/Iso)