Blood Pressure Evaluation Measures

Once a company has conducted assessment and planning for blood pressure screening and control programs, and developed the specific tasks of implementation for these programs, it is time to develop the evaluation plan. This evaluation plan should be in place before any program implementation has begun.

Metrics for worker productivity, health care costs, heath outcomes, and organizational change allow measurement of the beginning (baseline), middle (process), and results (outcome) of workplace health programs. It is not necessary to use all these metrics for evaluating programs. Some information may be difficult or costly to collect, or may not fit the operational structure of a company. These lists are only suggested approaches that may be useful in designing an evaluation plan. For blood pressure screening and control programs, key areas of evaluation include measures to track improvements in blood pressure screening and control outcomes and organizational changes to support blood pressure screening and control such as:

  • Have the number of employees screened for high blood pressure increased over the past year
  • Have the number of employees with high blood pressure who made changes to their lifestyle (e.g., lost weight , quit smoking) following screening and counseling increased over the past year
  • Does the worksite offer on-site screening programs and referrals including lifestyle counseling for those employees with high blood pressure
  • Does the worksite have policies and environmental strategies regarding blood pressure screening and control

These measures are designed for employee group assessment. They are not intended for examining an individual’s progress over time, which would raise concerns of employee confidentiality. For employer purposes, individual-level measures should be collected anonymously and only reported (typically by a third party administrator) in the aggregate, because the company’s major concerns are overall changes in productivity, health care costs, and employee satisfaction.

In general, data from the previous 12 months will provide sufficient baseline information and can be used in establishing the program goals and objectives in the planning phase, and in assessing progress toward goals in the evaluation phase. Ongoing measurements every 6 to 12 months after programs begin are usually appropriate measurement intervals, but measurement timing should be adapted to the expectations of the specific program.

Hypertension is one of the 10 most expensive health conditions for U.S. employers.1

  • One in three Americans have high blood pressure and it is more common in African Americans and older adults2
  • Hypertension (i.e., high blood pressure) is the most common primary diagnosis in the United States and is responsible for 35 million office visits each year3
  • The estimated direct and indirect cost of High Blood Pressure for 2010 is $76.6 billion2

Chronic high blood pressure can cause heart disease, stroke, kidney disease, and blindness. The purpose of blood pressure screening is to identify people with high blood pressure levels and refer them for clinical evaluation and treatment.

In 2010, the economic costs of cardiovascular diseases and stroke were estimated at $444.2 billion, including $272.5 billion in direct medical expenses and $171.7 billion in indirect costs3

The United States Preventive Services Task Force recommends:

  • Clinicians screen adults aged 18 and older for high blood pressure

High blood pressure is treated by a combination of medication and lifestyle changes. Worksite programs related to physical activity, nutrition, alcohol use, stress, type 2 diabetes, and obesity can aid employees in reducing high blood pressure. Controlling blood pressure with medications is one of the most cost-effective methods of reducing premature cardiovascular morbidity and mortality.


1.  Campbell KP, Lanza A, Dixon R, Chattopadhyay S, Molinari N, Finch RA, editors. A Purchaser’s Guide to Clinical Preventive Services: Moving Science into Coverage. Washington, DC: National Business Group on Health; 2006.

2.  Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, Ford E, Furie K, Go A, Greenlund K, Haase N, Hailpern S, Ho M, Howard V, Kissela B, Kittner S, Lackland D, Lisabeth L, Marelli A, McDermott M, Meigs J, Mozaffarian D, Nichol G, O’Donnell C, Roger V, Rosamond W, Sacco R, Sorlie P, Stafford R, Steinberger J, Thom T, Wasserthiel-Smoller S, Wong N, Wylie-Rosett J, Hong Y; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics–2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119:e21-181.

3.  Heidenreich PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. Mar 1 2011;123(8):933—944. Epub 2011 Jan 24.