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September 20, 1976

Screening for Hypertension

Author Affiliations

Program Coordinator National High Blood Pressure Education Program Bethesda, Md

JAMA. 1976;236(12):1351. doi:10.1001/jama.1976.03270130015004

To the Editor.—  The National High Blood Pressure Education Program sincerely appreciates the editorial, "Hypertension: A Major Medical Care Challenge," by Dr Barclay (235:2327, 1976). We believe, however, that two statements regarding screening are subject to misinterpretation and may lead to inappropriate action and misinvestment of community health care resources. Dr Barclay notes that hypertension control requires a system of mass screening and that children should be encouraged to participate in mass screening programs.Our concern arises from the popular connotation of the term mass screening. Among the bulk of the lay public, most health care system managers and many health care providers, this term carries an image of supermarket, shopping mall, and church basement activity. We believe these approaches are not cost effective for case-finding or achieving control. Mass screening should be used only among populations that are grossly medically underserved or among well-served populations, at most, every five