Blood pressure control achieved using workplace-based programs

By Dr. Ananya Mandal, MDMar 4 2020

In a new study out of China, a wellness program based at the workplace was seen to improve blood pressure control among the participants. The study titled, “Effect of a Workplace-Based Multi-Component Intervention on Hypertension Control A Randomized Clinical Trial,” in the latest issue of the journal JAMA Cardiology.

The study was led by Dr. Zengwu Wang, of the Peking Union Medical College & Chinese Academy of Medical Sciences in Beijing, and Dr. Chun Chang of Peking University in Beijing.

What was the study about?

The researchers speculated that specific workplace-based interventions could benefit those with high blood pressure. They added that there had been very few studies that actually looked at the effectiveness of these workplace-based interventions on blood pressure control, and thus they undertook this study on the Chinese working population. The interventions they tried were multi-component, they wrote.

What was done?

This was a randomized clinical trial that spanned over 60 different workplaces across China. The workplaces were all located in 20 different urban areas explained the researchers. The study lasted between January 2013 and December 2014.

The participants were divided into two groups. The first group was the intervention group with 3178 participants, and the second group was the control group with 988 participants. A cross-sectional survey was conducted on the participants after the intervention. For each of the participants, there were two-year-long interventions. These had two distinct components. The first was a workplace-based wellness program that helped improve the cardiovascular health of the employees, and the second intervention was hypertension management protocol according to the guidelines. The latter was based out of a community health center. Over the 24 month study period, blood pressure was routinely monitored for the patients.

The primary outcome studied was the blood pressure control among the employees at the workplace after intervention or medication control of blood pressure. Lifestyle factors were also taken into account in the results.

For this study, a total of 4,166 patients were recruited. Of these, 3,178 belonged to the intervention group, and 988 belonged to the control group. The average age of the participants was 46.3 years, and of these participants, 3,451 were men (82.8 percent) and the rest women. At baseline, all the participants were on medications for blood pressure control, and adequate control was seen in 19.5 percent among the intervention group and 20.1 percent among the control group.

What was workplace intervention?

The interventions within the workplace based wellness program were as follows –

1. Cardiovascular disease health education using lectures, texts, posters, etc. for the employees
2. Diet intervention including sound nutritional advice, low salt consumption, availability of healthy food options at the workplace cafeteria.
3. Cessation of tobacco
4. Improvement of the physical environment of the workplace by increasing physical activity and reducing sedentary behavior
5. Physical activity promotion by improving sports and gymnasium facilities
6. Stress management using relaxation techniques, meditation, breathing, and tai chi.
7. Health screening including annual health checkups

Tai Chi. Image Credit: Oscar Tarneberg / Shutterstock

Apart from the wellness program was the hypertension management protocol that was based on the 2010 Chinese hypertension guidelines

Results

Results showed that after 24 months of the planned intervention, the rate of control of blood pressure among the intervention group was 66.2 percent compared to 44 percent among the control group. The team wrote that among the intervention group, the systolic blood pressure fell by an average of 5.8 mm of Hg, and diastolic blood pressure fell by an average of 3.6 mm of Hg. Over the months of follow up, there was a progressive increase in the rate of blood pressure control in the intervention group.

As additional findings on lifestyle factors, the team found that persons belonging to the intervention group had an 18.4 percent reduction in rates of drinking as well compared to the control group. There was a 22.9 percent reduction in the perceived stress among those in the intervention group. Salt consumption in diet fell by 32 percent among those in the intervention group compared to those in the control group.

Conclusions and future directions

The authors wrote that interventions based out of the workplace could benefit patients with high blood pressure by not only lowering blood pressure but also improving lifestyle factors such as stress, drinking, and salt consumption. The authors wrote in conclusion, “The intervention can, therefore, be considered for large-scale use or inclusion in hypertension control programs in workplaces in China and other countries.” They added, “A workplace hypertension management program can potentially have far greater reach and better accessibility among employees and should be considered for inclusion in hypertension control programs.”