Utility of occupational blood pressure screening for the detection of potential hypertension

A potential limiting factor in the detection and control of hypertension has been the assumption that a routine periodic sphygmomanometric blood pressure recording is characteristic of usual blood pressure throughout the activities of daily living. The relationship between routine periodic clinic blood pressure and ambulatory blood pressure was investigated in employed workers. Ambulatory readings were obtained at regular intervals using an automatic self-inflating and recording sphygmomanometer at home and at work. Mean ambulatory systolic and diastolic pressures were significantly higher than clinic pressures, both at home and at work, and in every position except reclining. Eleven of the 113 employees considered normotensive from clinic screening had an average of 46% of their diastolic ambulatory readings greater than or equal to 90. These persons may be considered functionally hypertensive. The authors suggest the need to focus attention on those persons with high-normal clinic blood pressures discovered in workplace screening.