The role of community-based blood pressure screening in improving hypertension care.

In their recent Viewpoint, Frieden and colleagues argue that mass blood pressure screening diverts resources from improving hypertension care. We present a counterargument that community-based blood pressure screening can complement health-care services by increasing hypertension detection, particularly in populations with limited access to health care. Opportunistic community-based screening can be delivered at relatively low cost and reach individuals who might not otherwise engage with health-care systems. In settings where access to health-care facilities is constrained, such approaches provide an additional route to identifying raised blood pressure and initiating further assessment. When implemented using validated blood pressure devices and standardised protocols, community-based screening can support accurate measurement, although confirmatory diagnosis and long-term management require linkage to health-care facilities. In addition to case detection, screening initiatives contribute to improved awareness of hypertension through community engagement and public health messaging. Increasing detection of raised blood pressure will be essential to improving population-level control. Community-based screening, alongside strengthened primary care, could form part of a broader strategy to address the global burden of hypertension.