A workplace-based multicomponent hypertension management program was found to reduce blood pressure (BP) and risk for major adverse cardiovascular events (MACE) and mortality among men with hypertension, according to a study published in the journal Hypertension.
The current analysis was a component of the Kailuan study, which was a dynamic cohort study conducted in China that recruited 101,517 employees in 2006-2007; 25,337 in 2008-2009; 10,519 in 2010-2011; 21,651 in 2012-2013; and 12,396 in 2014-2015. A population-based workplace wellness program comprised health education lectures and health promotion activities, and employees underwent free health checkups every 2 years. The subset of men (n=17,724) with hypertension were assessed for BP semimonthly and were given free antihypertensive medications. Cardiovascular outcomes were assessed through 2019.
A subset of 6120 workers with hypertension were propensity matched with 6120 controls, who were included in the wellness program but did not receive hypertension-based care. The hypertension and control groups had a mean age of 45.18±6.40 and 45.65±7.92 years; body mass index (BMI) was 26.15±3.41 and 26.06±3.42; systolic BP was 142.7±16.1 and 142.7±18.3 mm Hg; and diastolic BP was 94.1±10.5 and 94.1±11.2 mm Hg, respectively.
At year 10, systolic BP was reduced by 1.92 mm Hg among the hypertension cohort and had increased by 5.91 mm Hg among the controls (mean between-group difference, -7.83; 95% CI, -9.06 to -6.62 mm Hg). A similar pattern was observed for diastolic BP (mean between-group difference, -4.72; 95% CI, -5.46 to -3.97 mm Hg).
Compared with controls, the hypertension management program increased the likelihood of achieving BP control at 10 years (odds ratio [OR], 1.70; 95% CI, 1.41-2.06).
During an averaged follow-up of 8.7 years, 887 MACE occurred. Compared with controls, MACE were reduced by 17% among the hypertension management group (hazard ratio [HR], 0.83; 95% CI, 0.72-0.94). Stratified by event, the management program associated with a 32% decreased risk for cardiovascular disease mortality (HR, 0.68; 95% CI, 0.56-0.83) and 14% decreased risk for stroke (HR, 0.86; 95% CI, 0.74-0.99).
At an average follow-up of 9.0 years, 178 all-cause deaths occurred. Compared with controls, deaths were reduced by 29% (95% CI, 14%-42%) among the hypertension management program recipients.
The effect on the BP control was observed more among individuals with higher baseline BP, and the effect on MACE reduction was observed more among individuals with increased age and those with diabetes (all P <.05).
This study may have included motivation bias, as enrollment in the hypertension management program was voluntary.
“Our study shows that a multicomponent hypertension management program yielded significant improvements in long-term BP control and substantial reductions in cardiovascular events and mortality,” the study authors said.
Zhou Y-F, Chen S, Wang G, et al. Effectiveness of a workplace-based, multicomponent hypertension management program in real-world practice: a propensity-matched analysis. Hypertension. Published online December 8, 2021. doi:10.1161/HYPERTENSIONAHA.121.18305