A hypertension control program based on the workplace. Report on the Chicago Center

Area of Science:

• Public Health
• Cardiovascular Medicine
• Occupational Health

Background:

• Hypertension is a significant public health concern, necessitating effective screening and management strategies.
• Identifying and treating hypertension in occupational settings can improve population health outcomes.
• The Hypertension Detection and Follow-Up Program (HDFP) aimed to assess workplace-based hypertension control.

Purpose of the Study:

• To evaluate the efficacy of workplace-based hypertension screening and intervention.
• To assess the adherence and outcomes of a pharmacologic hypertension treatment regimen.
• To determine the feasibility of using workplace settings for hypertension control.

Main Methods:

• Screening of 7,151 individuals in Chicago companies identified 833 suspect hypertensives.
• 513 individuals had confirmed high diastolic pressure; half were referred to physicians, half to the HDFP.
• HDFP utilized a step-wise pharmacologic regimen with a multidisciplinary team to maximize adherence.

Main Results:

• 94% of those assigned to HDFP accepted treatment, with over 90% active at one year.
• Average diastolic pressure decreased from 102.6 mm Hg at screening to 83.1 mm Hg at one year.
• Efforts to mitigate treatment barriers (cost, convenience, understanding) improved program adherence.

Conclusions:

• The workplace is a viable and effective setting for hypertension screening and control.
• A comprehensive, supportive treatment program significantly improves hypertension management.
• Multidisciplinary teams and outreach efforts enhance patient adherence to long-term therapy.