Haynes R B, Sackett D L, Taylor D W, Gibson E S, Johnson A L
N Engl J Med. 1978 Oct 5;299(14):741-4. doi: 10.1056/NEJM197810052991403.
A study of hypertension in an industrial setting allowed us to confirm and explore an earlier retrospective finding that the labeling of patients as hypertensive resulted in increased absenteeism from work. After screening and referral, we found that absenteeism rose (mean +/- 1 S.E.) 5.2 +/- 2.3 days per year (P less than 0.025); this 80 per cent increase greatly exceeded the 9 per cent rise in absenteeism in the general employee population during this period. The main factors associated with increased absenteeism were becoming aware of the condition (P less than 0.01) and low compliance with treatment (P less than 0.001). Subsequent absenteeism among patients unaware of their hypertension before screening was not related to the degree of hypertension, whether the worker was started on therapy, the degree of blood-pressure control achieved or exposure to attempts to promote compliance. These results have major implications for hypertension screening programs, especially since absenteeism rose among those previously unaware of their condition, regardless of whether antihypertensive therapy was begun.
一项针对工业企业环境中高血压情况的研究，使我们得以证实并深入探究一项早期回顾性研究结果：将患者标记为高血压患者会导致工作缺勤率上升。经过筛查和转诊，我们发现缺勤率上升了（均值±1个标准误），每年增加5.2±2.3天（P＜0.025）；这80%的增幅大大超过了同期普通员工群体9%的缺勤率上升幅度。与缺勤率增加相关的主要因素是知晓自身病情（P＜0.01）以及治疗依从性低（P＜0.001）。在筛查前未意识到自己患有高血压的患者中，后续的缺勤情况与高血压程度、工人是否开始接受治疗、血压控制程度或为提高依从性所做的努力均无关。这些结果对高血压筛查项目具有重要意义，特别是因为在那些之前未意识到自身病情的人群中缺勤率上升了，无论是否开始了抗高血压治疗。
