Once assessment and planning have been completed, including analysis of the collected data, the next step is implementing the strategies and interventions that will comprise the workplace health program. The intervention descriptions on this page include the public health evidence-base for each intervention, details on designing interventions for blood pressure screening and control, and links to examples and resources.
Before implementing any interventions, the evaluation plan should also be developed. Potential baseline, process, health outcomes, and organizational change measures for these programs are listed under evaluation of blood pressure screening and control programs.
Blood pressure is the force of blood against the walls of arteries. Blood pressure is usually measured with a blood pressure cuff and stethoscope and is reported as the systolic pressure over the diastolic pressure. “Systolic” refers to the highest pressure the heart exerts against the arteries in each heart beat, and “diastolic” refers to the lowest pressure as the heart relaxes between beats.
High blood pressure or hypertension is defined as a diastolic blood pressure of 90 mm Hg or higher or a systolic pressure of 140 mm Hg or higher.1-2 Hypertension is one of the 10 most expensive health conditions for U.S. employers.3
- One in three Americans have high blood pressure and it is more common in African Americans and older adults4
- 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 year5
- The estimated direct and indirect cost of High Blood Pressure for 2010 is $76.6 billion4
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 costs6
The United States Preventive Services Task Forceexternal icon and the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7)5 recommends:
- Clinicians screen adults aged 18 and older for high blood pressure
In Rankings of Preventable Services for the U.S. Populationexternal icon, the Partnership for Prevention provides an approach to ranking preventive services according to their clinically preventable burden (CPB) and cost effectiveness (CE). CPB is the disease, injury and premature death that would be prevented if the service were delivered to all people in the target population. With this approach, blood pressure screening for adults aged 18 years and above received a ranking of 8 on a scale of 1-10, with 10 the highest ranking.
Controlling blood pressure with medications is one of the most cost-effective methods of reducing premature cardiovascular morbidity and mortality. A 12 to 13-point reduction in blood pressure can reduce the number of heart attacks by 21%, strokes by 37%, and all deaths from cardiovascular disease by 25%.3
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 prevention and reducing high blood pressure.
1. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services, 2nd Edition. Washington, DC: U.S. Department of Health and Human Services, 1996.
2. Your Guide to Lowering High Blood Pressure. Topic Page. National Heart, Lung, and Blood Institute.
3. 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.
4. 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.
5. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003; 42:1206–1252.
6. 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.