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A worksite hypertension control program was established for employees of the state of Maryland. Employees were screened for hypertension, and individuals identified as hypertensive were encouraged to seek care from community physicians. For those choosing not to seek such community care, a treatment program was initiated at the worksite. Of the 417 hypertensives identified, 54 (13%) elected to have their blood pressure treated at the worksite. Comparisons between the group choosing worksite care and the group choosing community care revealed that the worksite group was generally a higher risk group by virtue of having less awareness of their hypertension, being less likely to be on antihypertensive treatment, and being less likely to have their hypertension controlled by medication. This group made relatively little use of community physicians. Increases in hypertension treatment and control were greater in the worksite group after a 2-year follow-up examination. The project suggests an important role for worksite treatment programs for hypertension as a complement to existing community care.

Examinations which should not be regularly performed include: chest and lower back x-ray examinations in routine physical examinations; tuberculosis screening by chest radiography; chest x-rays for hospital admission of patients under age 40 (unless there is a clinical indication of chest disease); chest radiography in routine prenatal care, and mammographic examinations for women under age 50 who do not have symptoms or a positive history. X-ray examinations of possibly pregnant patients require appropriate measures to protect the fetus.

The use of nutritional supplements (vitamins, minerals) has been reported to be as high as 66% for individuals and 54% for households. Among medical patients in metropolitan areas, 66% of suburban private patients and 31% of urban clinic patients use supplements. Reported here are results of a survey to assess the use of nutritional supplements by rural family medicine patients. A sample of patients (N = 199) in one practice completed a standardized questionnaire, and 54% reported that they had taken supplements (primarily multivitamins) during the previous 6 months. The desire to assure good nutrition and less fatigue were the major reasons cited for supplement use; 50% were daily users, and 42% had used supplements for longer than 3 years.