Unrecognized high blood pressure. A major public health issue for the workplace

Hypertension continues to be prevalent in the general population despite the public's increased awareness of cardiovascular disease. Population-wide detection and prevention of hypertension are high priority goals within preventive health care. According to recent National Heart, Lung, and Blood Institute (NHLBI) guidelines, high normal blood pressure (BP) (systolic 130 to 139 mm Hg or diastolic 85 to 89 mm Hg) is not an innocuous condition (NHLBI, 1997). High normal BP is a detectable, modifiable, antecedent condition to overt hypertension. Little is known about the incidence of high normal BP in the general population and of its relationship to stress. This study examined the prevalence of high normal and hypertensive levels of blood pressure in a convenience sample of 94 volunteer employees from a midsize corporation. Blood pressure and level of reported stress were assessed. Findings revealed rates of 11% and 30% high normal and hypertensive blood pressure levels, respectively. Ninety-six percent of participants assumed their blood pressures were normal. As in other studies, those employees with hypertensive blood pressure reported higher stress levels than normotensive employees. However, the population with high normal BP did not report significantly higher stress levels than normotensive employees. These findings suggest high normal and hypertensive blood pressures are prevalent cardiovascular disease risk factors among employees in the workplace. Most employees are unaware of their elevated BP and the risk of high normal BP. Occupational health nurses are in a strategic position to take a proactive approach to population-wide hypertension prevention by initiating worksite BP screening and education programs.