Statement on High Blood Pressure in the Workplace

Alderman M.H. , “Improved Compliance with Antihypertensive Therapy: Lessons from the Worksite,” Cardiovascular Reviews and Reports, 2(9):909–917, September 1981.

Alderman M.H. Davis T.K. , “Blood Pressure Control Programs On and Off the Worksite,” Journal of Occupational Medicine, 22(3):167–170, March 1980.

Alderman M.H. Davis T.K. , “Hypertension Control at the Work Site,” Journal of Occupational Medicine, 18:793, December 1976.

Baer L. , “Hypertension in Health Care Providers: Effectiveness of Worksite Treatment Programs in a State Mental Health Agency,” American Journal of Public Health, 71(11):1261–1263, November 1981.

Blue Cross and Blue Shield Associations, Demonstration of Health Insurers' Roles in the Design and Implementation of Work-Site Based High Blood Pressure Control Programs, Chicago, Illinois, July 1, 1980.

Coburn H. , “Worksite High Blood Pressure Control Programs: How to Get Started,” Occupational Health Nursing, 29(11):22–23, 50, November 1981.

Collings G.H. , “New York Telephone Multiphasic Screening Program,” High Blood Pressure Control in the Worksetting, Proceedings of the National Conference, October 14, 1976, Washington, D.C., pp. 22–30.

Cox M. , “Case Study in HBP Control: Campbell Soup Company,” Occupational Health Nursing, 29(11):41–42, November 1981.

Foote A. Erfurt J.C. , “Controlling Hypertension: A Cost-Effective Model,” Preventive Medicine, 6(2):319–343, June 1977.

Hill M. , “Social Support and Hypertension, A Special Relationship: Co-Worker Social Support in Work-Site Hypertension Control,” Johns Hopkins University, unpublished paper, May 1982.

LaPointe M. Ormsby P. , “Case Study in HBP Control: Massachusetts Mutual Life Insurance Company,” Occupational Health Nursing, 29(11):39–40, November 1981.

Logan A. , “A Comparison of Community and Occupationally Provided Antihypertensive Care,” Journal of Occupational Medicine, 24(11):901–906, November 1982.

Logan A. , “Cost-Effectiveness of a Worksite Hypertension Treatment Program,” Hypertension, 3(2):211–218, March-April 1981.

Logan A. , “Work-Site Treatment of Hypertension by Specially Trained Nurses: A Controlled Trial,” Lancet, 2(8153):1175–1178, December 1, 1979.

Scarborough P. , “Case Study in HBP Control: Macalloy Corporation,” Occupational Health Nursing, 29(11):37–38, November 1981.

Schneider W.J. , “A Worksite Hypertension Control Program for Hospital Employees Utilizing Repetitive Monitoring,” Journal of Occupational Medicine, 23(2):91–93, February 1981.

Tilson E. , “Organization for Long-Term Management of Hypertension: The Trade Union as a Compliance Mechanism in the Treatment of Hypertension,” Bulletin of the New York Academy of Medicine, 52(6)714–717, August 1976.

Walworth C.C. Charman R.C. , “Industrial Hypertension Program in a Rural State,” Journal of the American Medical Association, 237(18):1942–1945, May 2, 1977.

• “Demonstration Programs in Hypertension Control in the Work Setting,” Westinghouse Electric Corporation. Vol. I: NTIS Publication No. PB-83-113365, $16.00. Vol. II: NTIS Publication No. PB-83-113373, $14.50.

Foote A. Erfurt J.C. , “Hypertension Control at the Worksite: Comparison of Screening and Referral Alone, Referral and Follow-up, and On-Site Treatment,” New England Journal of Medicine, 308(14):809–813, April 7, 1983.

Estimates of the number and percent of employed people with blood pressure readings greater than or equal to 160/95 mm Hg (or on antihypertensive medication) and blood pressures between 140/90 and 160/95 mm Hg were derived by applying national prevalence rates for each degree of hypertension (by age, race, and sex) to the U.S. employed population. The high blood pressure prevalence rates were based on the 1971–1975 National Health and Nutrition Examination Survey (NHANES I), Vital and Health Statistics Series 11, Number 221, National Center for Health Statistics, U.S. Department of Health and Human Services, April 1981, adjusted to account for hypertensives under control. The number of employed persons (in 1981) came from the 1982 Employment and Training Report of the President, U.S. Department of Labor.

The death rates from HBP-related cardiovascular disease were obtained from the Mortality Division of the National Center for Health Statistics. The age, race, and sex-specific death rates (for 1979) were then applied to the number of employed persons in the United States (in 1981). It should be noted that this estimate is not adjusted for the “healthy worker effect” and is based on the assumption of equal mortality rates for the employed and not employed populations.

The increased risks of specific cardiovascular disease for persons with elevated blood pressure were from the Framingham Study (18-year follow-up). They were cited in “Hypertension in Framingham,” by Kannel W.B. Sorlie P. , in Epidemiology and Control of Hypertension, Paul Oglesby (ed.), Symposia Specialists, Miami, Florida, 1975.

The number of work-loss days due to coronary heart disease, stroke, and hypertension were obtained from unpublished data provided by the Division of Health Interview Statistics, National Center for Health Statistics (1979 data from the Health Interview Survey). Morbidity costs in 1977 due to these diseases were estimated by the Division of Analysis of NCHS to be $1.24 billion. When inflated by the medical care component of the Consumer Price Index to 1982 dollars (by a factor of 162), this amounts to over $2 billion.

The number of deaths resulting from industrial accidents in 1981 was estimated by the National Safety Council in Chicago, Illinois.

“Current Population Survey,” 1981, U.S. Department of Labor. Bureau of Labor Statistics.

Hypertension Detection and Follow-up Program Cooperative Group, “Five-Year Findings of the Hypertension Detection and Follow-up. I, Reduction in Mortality of Persons with High Blood Pressure, including Mild Hypertension, and II. Mortality by Race, Sex, and Age,” Journal of the American Medical Association, 242(23):2562–2577, December 7, 1979.

National Center for Health Statistics, Michael Rowland and Jean Roberts, “Blood Pressure Levels and Hypertension in Persons Ages 6–74 Years: United States, 1976–1980,” Advance Data from Vital and Health Statistics, No. 84. DHHS Pub. No. (PHS) 82–1250. U.S. Public Health Service, Hyattsville, Maryland, October 8, 1982.

High Blood Pressure Control in the Worksetting, Proceedings of the National Conference, October 1976, Washington, D.C., National High Blood Pressure Education Program, Bethesda, Maryland, 1977.

Babbitz M.A. , “The Occupational Health Nurse: Leader in Worksite High Blood Pressure Control,” Occupational Health Nursing, 29(11):11, November 1981.

Hannan EL Graham J.K. , “A Cost-Benefit Study of a Hypertension Screening and Treatment Program at the Work Setting,” Inquiry, 15:345–358, December 1978.

Hauver J.H. Goodman J.A. , “The Evaluation of Performance and Cost in a Hypertension Control Program,” Medical Care, 17(5):485–502, May 1980.

Ruchlin H.S. Alderman M.H. , Cost of Worksite Hypertension Treatment, U.S. Department of Health and Human Services, National Institutes of Health, NIH Publication No. 80–2215, October 1980.

Mroczek W.J. , “Antihypertensive Therapy and Reduced Life Insurance Premiums,” Annals of Internal Medicine, 88(5):706–707, May 1978.

Levy R.I. , “Controlling High Blood Pressure: The Insurance Business Can Contribute,” Response, 9(1):15–16, January 1980.

Kiefhaber A. , A Survey of Industry Sponsored Health Promotion, Prevention and Education Programs, Washington, D.C., Washington Business Group on Health, January 1979.

Society of Actuaries and Association of Life Insurance Medical Directors of America, Blood Pressure Study 1979, November 1980.

Schiffman J. , “The Framingham Study, Section 26, Survival Following Certain Cardiovascular Events,” Government Printing Office, Washington, D.C., September 1970.

Bolt W. , “A Study of Moderate and Severe Hypertension,” Transactions of the Association of Life Insurance Medical Directors of America, 41:61–100.

Perry M.H. , “Veterans Administration Cooperative Studies of Hypertension,” Angiology, November 19, 1978, pp. 804–816.

Sackett D.L. , “Patient Compliance with Antihypertensive Regimens,” Patient Counseling and Health Education, 1(1):18–21, 1978.

Ward G.W. , “Changing Trends in Control of Hypertension,” Public Health Reports, 93(1):31–34, January/February 1978.