The employee high blood pressure program of the National Institutes of Health.

Adequate control of high blood pressure remains a significant problem for many hypertensives detected through screening programs. The worksite is an ideal place in which to help workers control their high blood pressure. The Occupational Medical Service (OMS) at the National Institutes of Health developed and implemented a protocol to screen, refer, follow up, and monitor hypertensive employees. Approximately one-half of the workers were screened at a cost of $1.70 per employee. Alternative approaches to improving the effectiveness of a building-to-building screening program were suggested. Of the employees screened, 85.3 percent had normal blood pressure, 7.8 percent had borderline blood pressure, and 6.9 percent had high blood pressure. The two-steps screening process reduced by one-third the number of persons referred for evaluation of persistently high blood pressure. Among the hypertensive employees on treatment, 53.7 percent had normal readings. Of the 263 newly diagnosed and poorly controlled hypertensives who were referred to their private physicians for care, 73 percent were actually evaluated. Measures to increase the likelihood of a successful referral and followup included providing a list of medical resources in the community and assigning a nurse rather than a clear to contact employees for a repeat blood pressure check. Monitoring and education services are being provided to 70 percent of the known hypertensives. Adequate blood pressure control in NIH employees has improved by one-third as a result of the program.