Efficacy of screening for high blood pressure in dental health care
1 Uppsala University, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology Section, Uppsala, Sweden
2 Centre for Clinical Research Uppsala University/County Council of Gävleborg, Gävle, Sweden
3 Public Dental Service, County Council of Gävleborg, Gävle, Sweden
4 Uppsala University, Department of Medical Sciences, Uppsala, Sweden
5 University of Gothenburg, Department of Odontology, Gothenburg, Sweden
BMC Public Health 2011, 11:194 doi:10.1186/1471-2458-11-194Published: 30 March 2011
There is consensus on the importance of early detection and treatment of high blood pressure. Dental care is one of few medical services to which a considerable proportion of the general population comes for regular check-ups. We tested the effects of blood pressure screening in dental care centres with subsequent work-up of subjects screening positive in primary health care (PHCC).
Altogether 1,149 subjects 40-65 years old or 20-39 years old with body mass index >25, and with no previously known hypertension, who came for a dental examination had their blood pressure measured with an Omron M4® automatic blood pressure reading device. Subjects with systolic blood pressure readings above 160 mmHg or diastolic above 90 mmHg were referred to their PHCC for a check up. Outcome data were obtained by scrutiny of PHCC and hospital patient records for hypertension diagnoses during the three years following screening.
237 (20.6%) subjects screened positive. Of these, 230 (97.1%) came to their PHCC within the 3-year follow-up period, as compared with 695 (76.2%) of those who screened negative (p < 0.0001). Of those who screened positive, 76 (32.1%) received a diagnosis of hypertension, as compared with 26 (2.9%) of those who screened negative. Sensitivity was 79.1%, specificity 84.8% and positive predictive value 30.1%. The number of subjects needed to screen to find one case of hypertension was 18.
Co-operation between dental and primary care for blood pressure screening and work-up appears to be an effective way of detecting previously unknown hypertension.