Evidence summary of benefits associated with hypertension screening: The mean follow-up was 1 y. Each end point was assessed using mean cumulative hospital rates from 1 RCT.15 There was no serious risk of bias in this trial. There are no concerns about lack of blinding, as blinding is part of the intervention and therefore there is no risk of bias. There was no serious inconsistency, as only a single study was used (inconsistency is not applicable). There was serious indirectness, as the study focused on the population > 65 y of age (although younger patients were not denied participation); therefore, the study results are not generalizable to the general population. In addition to hypertension screening, the intervention included comprehensive cardiovascular risk assessment and education sessions. The efficacy of hypertension screening in isolation was not directly assessed. There was no serious imprecision seen in the trial. There was an insufficient number of studies to assess publication bias. The study was of moderate quality and critical importance.
| END POINT | PATIENTS, N (%) | EFFECT RELATIVE (95% CI)* | ABSOLUTE NO. PER 1 000 000 (95% CI) | |
|---|---|---|---|---|
| KQ1 SCREENING (N = 69 942) | CONTROL, NO SCREENING (N = 75 499) | |||
| Composite | 1951 (2.8)† | 2275 (3.0)† | RR 0.91 (0.86 to 0.97) | 2712 fewer (904 fewer to 4219 fewer) |
| Acute myocardial infarction | 667 (1.0)† | 816 (1.1)† | RR 0.87 (0.79 to 0.97) | 1405 fewer (324 fewer to 2270 fewer) |
| Congestive heart failure | 735 (1.1)† | 923 (1.2)† | RR 0.90 (0.81 to 0.99) | 1223 fewer (122 fewer to 2323 fewer) |
| Stroke | 550 (0.8)† | 536 (0.7)† | RR 0.99 (0.88 to 1.12) | 71 fewer (852 fewer to 852 more) |
| All-cause mortality | 2377 (3.4)‡ | 2608 (3.5)‡ | RR 0.98 (0.92 to 1.04) | 684 fewer (2618 fewer to 1368 more) |
KQ1—key question 1, RCT—randomized controlled trial, RR—relative risk.
↵* These outcomes represent the effect of the Cardiovascular Health Awareness Program. Outcome measures reported have been adjusted for hospital admission rates in the year before the intervention.
↵† Calculations based on mean cumulative admissions.
↵‡ Calculations based on the number of unique admissions.
Data from Kaczorowski et al.15