Overall hypertension programs that include a mechan i

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Overall, hypertension programs that include a mechan- i sm f or ensuring continuing control , through on si te contin- Employee Health Programs/Fielding i··· .... " , ,. ~: ~ ~
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uin g tre atm ent or ref erra l an d aggressive foll ow-u p, ar e gen era lly effective in redu ci ng car di ovasc ular ri sk. Despite some sugges ti on that b en efits to emp loyees exceed costs, neith er the methodology nor va lu es for key va ri ab les hav e been suf fici ently worked o ut to establish this point for rn os ); worksite s it ua tions. Smoking Thousands of epidemiological studies have shown a very str ong relatio ns hip to excess incid e nce of heart disease, stroke, emph ysema j other r es pira tory illne ss and many cancers, most notably cancer of the lungs, esophagus, oropharynx and bladder.'"-20 F or examp le , age-standard- iz ed co ronary he a rt dise ase death r ates for 2+ packs-a-day male smokers arc 335% of that of nonsmokers in the 45 thr ough 54 decade and 213% of nonsmoking rates for the 55 thr o ugh 64 age ra ng e. Ci gare tte smok ing women ha ve a stroke death rate 211% of nvnsmokers in the 45 through 54 age range and 154% of the nonsmokers rate for ag es 55 thr ough 64. Cancer mortality ratios for cigarette smoking men compared with nonsm oke rs in one study were 8.53 for lung, 3.96 for esophagus, 6.52 for buccal pharynx and larynx and 2.55 fo r bladder. A very large 15-year actuarial study by a major in surance car ri er of th e ac tual d ea th experience of smokers and nonsmokers found the fo ll owing mortality ratios (smoker to nonsmoke r) : respiratory cancer, 15.0; pneum o nia and influen za, 14.7; arteriosclerosis a nd degenerative hear t dis e as e and myoca rdi al in sufficiency, 2.7; l1yp e rt e nsive heart disease and hypertension, 8.1; digestive disease s, 8.1 ; and moturcycle accidents, 2.2.18 Da ta from th e Health Interview Survey of approximately 12,000 people in late 1978 and early 1979 rev ealed th at 33.7% of persons aged 17 and over smoke (37.4% of men, 30.4% of women).!9 The same survey found 20.3% r e- ported that they were exsmokers (27.4% of men and 13.9% of women). Pr ojections from the sample data suggest that about 60% of the over 50 million current adult cigarette sm okers have tried to stop at some time. An estimated 13.5 million people had made an attempt to stop in the 12 months prior to completing the s urv ey. The good news for smokers who stop is th at t heir sm oking-related increased risk for those serious diseases declin es after cessation. Postmyocardial infarction rehabili- tat ion patients who discontinue sm ok ing halv e their risk of subsequent myocardial infarction a nd ca rdi ovasc ul ar dis ease death. 21 For th e average smoker, cessation reduce s corona ry heart disease mortality risk from 200% to 150% of that of nonsmokers w ithin one yea r, and within fi ve to 10 years th e mor t -': ' : rate f or exsmo kers is v irtuall y equivalent to that msmokers. 17 Lung canc er risks al so de cl ine after smokiJ,Eo cessation, although at a slower pac e.
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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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