5 many companies have reported their hypertension pro

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5 Many companies have reported their hypertension pro- grams successful in identifying employees who were una· ware that they h ad hypertension and in increasing the per- centage of hypertensives under adequate contra:' ror example, a voluntary ansite screening, referral and fOliow- up program at the home office of Ma ssac huset!$ Mutual Life Insurance Company led to an increase in the percent- age under control from 36% to 82% af ter one year of operation. 6 In a three·site industrial hypertension screening, detec· tion and follow·up program, 92 % of 120 auto workers, 138 sanitation workers and 106 postal workers referred for high blood pressure (> 160/95 mm Hg) saw their physician, and 93% of those seeing a physician had tr(,ltment initi- atedJ Of those initiating treatment , about 84% showed progress towards control (readings <140/90 mm Hg or re- duced since scroening and <160/9S mm Hg) with an avcr· age follow·up time of 16 months . In 218 Chicago·area hypertensive employees who attended a s~ecial high blood pressure control clinic near their work place, average diastolic blood pressure fell from 102.6 mm Hg at first screening and 98 .8 mm Hg at second screening to 83.1 mm Hg at the end of the first yearS In another study , 8,467 members of three unions cov· ered under employer - supported Health and Security Plans were screened and treated for hyperten sion (systolic blood pressure;> 160 mm Hg and/or diastolic ;> 95) at a site near their work ba se d on a stepped protocol. 9 Of the total, 16.7% were found to be hypertensive, and of these, 85.7% were already aware of their condition and 66.1% were already under treatment. Eighty percent of those volun- teering to have care delivered at the clinic e ; ~her attained or maintained a blood pressure less than or equal to 160/95 mm Hg or had a 10 % or greater reduction in blood pressure. Disability days for the hypertensives identified and treated onsite, or by their own physician, declined an average of 25.3% and 30.9% in the next two years, while disability for all employees increased an average of 9.2%. Hospitalization days for cardiovascular problems decreased dramatically for those treated onsite but not for those tested at their usual source of care over a three-year period. By contrast, a Canadian study of male employees of Dominion Foundries and Steel found that absenteeism in· creased an average of 5.2 days per year (80% over baseline) after the diagnosis of hypertension was made, presumably because employees hearing that they had a health problem increased sick role behavior. lO Increased absenteeism was unaffected by in stitution of antihyperten sive therapy or degree of control ac hieved. A number of models have been advanced to assess cost- benefi t and cos t- eff ec tiveness of industrial hypertension detection and control programs. Available data suggest that 908 ons ite treatment ma y be mor e cost-effective than com- munity care. For example, in one study 457 hypertensive volunteers aged 18 to 69, from 41 busin ess locations in Metropolitan Toronto, were randomly ass igned to worksite or community (regular) care.
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  • Spring '12
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  • th e average, th ese programs, th ese program, al th prohssionals, th e work

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