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Repetitive screening: An effective and efficient means of reinforcing hypertension control at the work site
154
ABSTRACTS:
HIGH
BLOOD
PRESSURE
CONTROL
A-67
AHRIJLATORY HDNITORINC OF ANTIHYPERTENSIVE THERAPY Yolanda Michigan
Durlcy, 48206;
Wayne State University, Metropolitan Robert Cubberley; Shelia Thomas
Hospital,
1800 Tuxedo,
Detroit,
Antihypertensive therapy is generally a lifetime commitment for the patient. Careful monitoring of each medication is a mandatory function in order to prevent foreFor the hypertension clinic at fletropolitan Hospital seeable drug related problems. we’ve developed a check list to help monitor the toxicities and precautions of each The parameters of each check list consist of medication at designated intervals. For methyldopa we knou that laboratory results, subjective and objective data. it’s contraindicated in patients with a hypersensitivity to the compound may occur; If anemia occurs, studies should history of previous liver dysfunction or anuria. Patients on continous therapy, be preformed to determine the presence of hemolysis. This rarely occurs during the IO-20% may develope a positive direct Coombs test. first.six months of therapy and if it is not encountered within twelve months it is unlikely to develop. Jaundice with or without fever may develop, usually within Bradycardia. psychic disturbances, orthostatic the first 2-j months of therapy. hypotension, fluid retension, drowsiness and sexual impotence are well known preOur check list for methyldopa includes the following parameters: cautions. Six--Eight weeks Six--Months Prior to initiation of therapy Hemoglobin/Hematocri t Hepatic Function Hx of previous liver disease CBC with Differential Di rect Coombs Test Hepatic Function Renal Status Joint pain Serum Alkaline Phos. Skin Rash Sexual Function Serum Transaminases Fever without infection Nightmares Renal Status Urinalysis Joint pain Depression Drowsiness Serum Creatine Previous positives Lightheadedness Sexual Hx Renal Status CRC with Differential with movement A-68
REPETITIVE SCREENING: AN EFFECTIVE AND gFFICIENT TENSION CONTROL AT THE WORK SITE hark Dykan, Montefiore Hospital 10467; William Schneider; Linda
and Medical Rolcun.
Center,
MEANS OF REINFORCING HYPER111 E. 210th
St.,
Bronx,
N.Y.
Where employment settings are utilized for hypertension control programs, the usual approach has been to administer anti-hypertensive therapy through work site the inability to reach the popuor work-related clinics. Shortcomings include lation who decline this treatment, transient impact on those who leave the local work force, and the inherent costs involved. In our medical center with over 5000 employees, we have utilized a repetitive blood pressure screening procedure during the past 18 months to reinforce the need for and to determine the adequacy of hypertension control, regardless of source. All employees undergo blood pressure determinations at no more than t*lr, year intervals. Those found to have diastolic pressures of 90 naHg or more (507) are checked semi-annually at their actual work stations by a physician’s assistant. Rovision is made for this examination to be carried out in the Employees’ Health Service for the 9 percent who prefer this approach. Eighty-one percent of the employees receiving medical attention for hypertension exhibited adequate control; 60 percent of those individuals, poorly controlled at first, are now normotensive. Seven percent were found not to be under care and were appropriately referred. Only 8 parcent declined examination, indicating general acceptance of the program. No additional staff or funds have been required for implementation of the program. This type of approach to blood pressure control at the work site is effective, well-accepted, and economical.
ABSTRACTS:
HIGH
BLOOD
PRESSURE
CONTROL
A-67
AHRIJLATORY HDNITORINC OF ANTIHYPERTENSIVE THERAPY Yolanda Michigan
Durlcy, 48206;
Wayne State University, Metropolitan Robert Cubberley; Shelia Thomas
Hospital,
1800 Tuxedo,
Detroit,
Antihypertensive therapy is generally a lifetime commitment for the patient. Careful monitoring of each medication is a mandatory function in order to prevent foreFor the hypertension clinic at fletropolitan Hospital seeable drug related problems. we’ve developed a check list to help monitor the toxicities and precautions of each The parameters of each check list consist of medication at designated intervals. For methyldopa we knou that laboratory results, subjective and objective data. it’s contraindicated in patients with a hypersensitivity to the compound may occur; If anemia occurs, studies should history of previous liver dysfunction or anuria. Patients on continous therapy, be preformed to determine the presence of hemolysis. This rarely occurs during the IO-20% may develope a positive direct Coombs test. first.six months of therapy and if it is not encountered within twelve months it is unlikely to develop. Jaundice with or without fever may develop, usually within Bradycardia. psychic disturbances, orthostatic the first 2-j months of therapy. hypotension, fluid retension, drowsiness and sexual impotence are well known preOur check list for methyldopa includes the following parameters: cautions. Six--Eight weeks Six--Months Prior to initiation of therapy Hemoglobin/Hematocri t Hepatic Function Hx of previous liver disease CBC with Differential Di rect Coombs Test Hepatic Function Renal Status Joint pain Serum Alkaline Phos. Skin Rash Sexual Function Serum Transaminases Fever without infection Nightmares Renal Status Urinalysis Joint pain Depression Drowsiness Serum Creatine Previous positives Lightheadedness Sexual Hx Renal Status CRC with Differential with movement A-68
REPETITIVE SCREENING: AN EFFECTIVE AND gFFICIENT TENSION CONTROL AT THE WORK SITE hark Dykan, Montefiore Hospital 10467; William Schneider; Linda
and Medical Rolcun.
Center,
MEANS OF REINFORCING HYPER111 E. 210th
St.,
Bronx,
N.Y.
Where employment settings are utilized for hypertension control programs, the usual approach has been to administer anti-hypertensive therapy through work site the inability to reach the popuor work-related clinics. Shortcomings include lation who decline this treatment, transient impact on those who leave the local work force, and the inherent costs involved. In our medical center with over 5000 employees, we have utilized a repetitive blood pressure screening procedure during the past 18 months to reinforce the need for and to determine the adequacy of hypertension control, regardless of source. All employees undergo blood pressure determinations at no more than t*lr, year intervals. Those found to have diastolic pressures of 90 naHg or more (507) are checked semi-annually at their actual work stations by a physician’s assistant. Rovision is made for this examination to be carried out in the Employees’ Health Service for the 9 percent who prefer this approach. Eighty-one percent of the employees receiving medical attention for hypertension exhibited adequate control; 60 percent of those individuals, poorly controlled at first, are now normotensive. Seven percent were found not to be under care and were appropriately referred. Only 8 parcent declined examination, indicating general acceptance of the program. No additional staff or funds have been required for implementation of the program. This type of approach to blood pressure control at the work site is effective, well-accepted, and economical.