Abstract
This study was designed to assess advantages and cost-effectiveness of community control of hypertension at the worksite in a metallurgical factory in Pavia. Under consent of managers and trade-unionists, a screening program was undertaken. 2701 subjects (95% of the total number of employees) were screened: 277 (10.2%) were hypertensive, 101 (38%) did not know to be hypertensive, 56 (22%) knew to be hypertensive but they were untreated and only 20 (8%) of those under treatment were adequately treated. Of the 277 essential hypertensives, 262 (94%) adhered to the program. They were assigned to beta-blocking or diuretic treatment following WHO rules. Then an aggressive follow-up was started (the hypertensives were periodically called to control at the worksite). 257 (98%) were partecipants 1 year later. Our worksite hypertension control program allowed us to identify many cases of undiagnosed or untreated hypertension and to start an early treatment. One year after entry, the percentage of hypertensives achieving a normal blood pressure (85%) was almost twice as that obtained by conventional clinical approach employing the same type of treatment. Besides, more than 95% of hypertensives remained under control at 1 year. Regarding the costs, it is difficult to generalize, but our study suggests that, if there is the will, it is possible to realize programs of hypertension community control at a very low cost (in our experience: 43 dollars per hypertensive per year).
Similar content being viewed by others
References
Alderman M.H. and Schoenbaum E.E. (1975): Detection and treatment of hypertension at the worksite. - N. Engl. J. Med. 293: 65–68.
Alderman M.H. and Davis T.K. (1976): Hypertension control at the worksite. - J. Occup. Med. 18: 793–96.
Alderman M.H. and Davis T.K. (1978): Hypertension control in occupational setting. - N.Y. State J. Med. 78: 1287–91.
Alderman M.H. and Davis T.K (1980): Blood pressure control programs on and off the worksite. - J.O.M. 22: 167–70.
Ambrosio G.B., Zamboni S., Gabaldo S.et al. (1978): L'ipertensione arteriosa nella comunità: valutazione dello stato di controllo di una popolazione generale. -G. Ital. Cardiol. 8: 1161-
Charman R.C. (1974): Hypertension management program in an industrial community. - J.A.M.A. 227: 287–91.
Erfurt J. C. and Foote A. (1982): Hypertension control in the work setting: the University of Michigan-Ford Motor Company demonstration Program. Springfield, Va: National Techinical Information Service (NTIS publication n. PB-83-113399).
Fogari R., Orlandi C., Rogledi D. and Finardi G. (1982): Prevalenza dell'ipertensione arteriosa essenziale fra gli operai di una fabbricca metalmecccanica. Effettii della monoterapia a lungo termine con un beta,-antagonista. - G. Ital. Med. Lav. 4: 221–24.
Fogari R., Orlandi C., Bellomo G., Marchesi E. and Finardi G. (1985): Essential hypertension among workers of a metallurgical factory: results of chronic treatment with a selective beta-antagonist. In: Rosenfeld J.B., Silverberg D.S., Viskoper R. Eds : Hypertension control in the Community. - Libbey London, p. 57–61.
Foote A. and Erfurt J.C. (1977): Controlling hypertension: a cost-effective model. - Prev. Med. 6: 319–343.
Foote A. and Erfurt J.C. (1983): Hypertension control at the worksite. - N. Eng. J. Med. 308: 809–13.
Haynes R.B., Sackett D.L. and Taylor D.W. (1978): Pratical management of low compliance with antihypertnsive therapy: a guide for the busy practitioner. - Clin. Invest. Med. 1: 175–80.
Hypertension Detection and Follow-up Program Cooperative Group: Five-year findings of the hypertension detection and follow-up program: reduction in mortality of persons with high blood pressure, including mild hypertension. - J.A.M.A. 1979, 242: 2562–71.
Kannel W.B., Wolf P.A., Verter J.et al. (1970): Epidemiologic assessment of the role of blood pressure in strokes: the Framingham Study. -J.A.M.A. 214: 301.
Kannel W.B. and Gordon T. (1976): The Framingham Study-an epidemiological investigation of cardiovascular disease. - Sec 31, VSDHEW, Washington.
Kochar M.S., Itskowitz J.D. and Panagis C. (1979): Hypertension control among patients referred by a community blood pressure screening program. - J. Chron. Dis. 32: 493–97.
Logan A.G., Milne B.J., Campbell W.P. and HaynesR.B. (1981): Cost-effectiveness of a work-site hypertension treatment program. - Hypertension 3: 211–18.
18.Logan A.G., Haynes B., Milne B., Achber C., CampbellW.P. and Flanagan T. (1985): Hypertension control in industry: alternative strategies. In: RosenfeldJ.B., SilverbergD.S., ViskoperR. Eds (1985): Hypertension control in the Community. - Libbey J., London, p. 57–61.
McClellan W. and Wilber J.A. (1985): A decade's experience with hypertension control programs in the United States: the empirical basis for a model of community hypertension control programs. In: RosenfeldJ.B., SilvergergD.S., ViskoperR.: Hypertension control in the Community. - Libbey J., London, p. 1–6.
National Heart, Lung and Blood Institute (1978): National high blood pressure education program. Information memorandum n. 13, Bethesda.
Nugent C.A. and Gerlach B.A (1980): Hypertension control: the role of screening and referral to community physicians. - Prev. Med. 9: 569–77.
Ontario Council of Health (1977): Areport of the Ontario Council of Health: hypertension. Toronto, Ontario: the ontario council of health.
Puska P., Tuomileto J. and Nissinen A. (1985): Community based control of hypertension: results and experiences from the North Karelia Project. In: RosenfeldJ.B., SilverbergD.S., ViskoperR. Eds: Hypertension control in the Community. - Libbey J., London, p. 22–24.
Ruchlin H.S. and Alderman M.H. (1980): Cost of hypertension control at the workplace. - J.O.M. 22: 795–800.
Salonen J.T. (1985): Impact of mild hypertension on the risk of coronary and cerebrovascular disease and death. In: RosenfeldJ.B., SilverbergD.S., Viskoper R. Eds: Hypertension control in the Community. -Libbey J., London, p. 91–95.
Schoenberg J.A., Stamler J., Shekelle R.B. and ShekelleS.O. (1972): Current status of hypertension control in an industrial population. - J.A.M.A. 222: 559–62.
Shapiro M., Bleho J., Curran M., Farrel K.et al. (1978): Problems in the control of hypertension in the community. - Can. Med. Assoc. 118: 37–40.
The Pooling Project Research Group (1978): Relationship of blood pressure, serum cholesterol, smoking habit, relative weitht and ECG abnormalities to incidence of major coronary events: final report of the Pooling Project. - J. Chron. Dis. 31: 201–206.
U.S. Department of Health, Education and Welfare : Health and nutrition examination survey 1971–1974. Vital and Health Statistics, Series 11, n. 203. Washington D.C.: Public Health Service Publication.
Walworth C.C. (1980): Industrial hypertension control program in a rural state. - J. South Car. Med. Assoc. 76: 75–82.
Who (1973): Community control of hypertension. Methodological considerations and a protocol of a Who cooperative project. - Cud/74, Geneva
Who-Ish (1983): Guidelines for the treatment of mild hypertension. Memorandum from a Who meeting. -Lancet 1: 457–58.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Fogari, R., Poletti, L., Tettamanti, F. et al. Community control of hypertension at the worksite in a metallurgical factory: Results of 1-year follow-up. Eur J Epidemiol 5, 164–169 (1989). https://doi.org/10.1007/BF00156823
Issue Date:
DOI: https://doi.org/10.1007/BF00156823