Spain changed its health services system, in the mid 1980s, to make it more primary care-oriented. This was done in three waves, starting with the most socially disadvantaged areas. This chart shows that the percentage decline in mortality associated with hypertension was greatest in the areas that were reformed first, even though they were the most deprived.

(In contrast, this was not the case for the decline in perinatal mortality, which was not expected to be influenced by primary care.)

Source: Villalbi JR, Guarga A, Pasarin MI, Gil M, Borrell C, Ferran M et al. An evaluation of the impact of primary care reform on health. Aten Primaria 1999; 24(8):468-474.