Detection and Treatment of Hypertension at the Work Site

A program linking detection to treatment was designed to improve blood-pressure control among adults with asymptomatic, uncomplicated hypertension. Key elements of this program were provision of all diagnostic and therapeutic services at work site, integration of delivery system with the administration of a labor union, adherence to a rigid protocol, and continuous patient surveillance by nurses and paraprofessionals. At the first program site, Gimbels's principal New York City department store, 84 per cent of 1850 employees were screened, and 65 per cent of 186 with confirmed hypertension elected the treatment program. Of the 94 patients followed for one year, 97 per cent remained under therapy, with no untoward effect, and 81 per cent of patients had satisfactory blood-pressure reduction. This approach appears to be a safe, effective, and acceptable method for hypertension control in large numbers of patients. (N Engl J Med 293:65–68, 1975). A PROGRAM to identify and treat employed persons with asymptomatic, uncomplicated hypertension has been developed for members of the United Store-workers Union. Its strategy has been to facilitate access to care in an environment conducive to long-term patient compliance. The key elements of the program are provision of all diagnostic and therapeutic services at the work site, delivery of care within a cohesive union structure, adherence to a rigid protocol, and continuous patient surveillance by nurses and paraprofessionals under physician supervision. The purpose of this report is to describe the system of care and the experience of patients treated at.