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May 24, 1976

Hypertension: A Major Medical Care Challenge

JAMA. 1976;235(21):2327. doi:10.1001/jama.1976.03260470045028

Many people mistakenly believe that health care is synonymous with medical care. Health is, to a large degree, a matter of personal responsibility that must be exercised within the limits of genetic endowment. Educational achievement, income, and environment are also important factors. As a general rule, however, medical care has relatively little impact on health. Measurements that supposedly reflect health, such as morbidity, longevity, growth, and development, are not measures of the quality of medical care being received.

There are, however, exceptions to general rules, and this issue of The Journal focuses attention on such an exception. The detection and treatment of hypertension, which can unequivocally be defined as medical care, has been shown to reduce morbidity and mortality. If 55% of the population suffers from some degree of hypertension, as found by the Community Hypertension Evaluation Clinics Program (CHEC) (p 2299), then appropriate medical management would make a substantial