- Email: [email protected]
Hypertension control achieved by men randomized into the special intervention group of the multiple risk factor intervention trial at twenty-four months
158
ABSTRACTS:
HIGH
BLOOD
PRESSURE
CONTROL
A-75
Whitney Evans, National Health Watch, Inc., 44132; Martin Saidlerrmn; Nonnan H. Daily
27801 Euclid
Avenue, Cleveland,
Ohio
In 1976, Health Watch developed and introduced a conprehensive Worksite hypertension control program to determine whether a private company could rrmnage and was to operate medically rrarket a financially viable program. Our objective sound and successful programs at revenue levels assuring sufficient funds to m years of experience resulted in attract qualified medical professionals. (1) medically successful programs with excellent patient acceptance, 9% control, with average diastolic pressures of 81.3; and (2) financial failure due to minimal employer acceptance of a cost effective program at less than $200 per Obstacles to employer acceptance have been reluctance to patient annually. sponsor "treatment" programs; unwillingness to spend today's dollars for prevention of future disability and death; lack of support in dmnstration programs and in llprbidity evaluations by health insurance companies; opposition by medical societies; and lack of federal funding directed toward alleviation We feel key obstacles can be overccme by (1) of the aforementioned obstacles. "seed rmney" from federal sources and insurance conpsnies for initiation of programs; (2) involvement of nationally known leaders in hypertension in explaining worksite program benefits to medical societies; and (3) conmitment to trial programs by medical directors of major American companies including the federal govenunent.
A-76 HYPERTENSIONCONTROLACHIEVEDBY MENRANDOMIZEDINTO THE SPECIAL INTERVENTION GROUPOF THE MULTIPLE RISK FACTORINTERVENTIONTRIAL AT TWENTY-FOUR MONTHS L. Falvo-Gerard, University of Pittsburgh, Graduate School of Public 130 DeSoto Street, Pittsburgh, Pennsylvania 15261; Lewis H. Kuller.
Health,
The Multiple Risk Factor Intervention Trial (MRFIT) provides an idealized model for hypertension control. Of the 6,428 men randomized into a special intervention (S.I.) group for cardiovascular risk factor reduction 92% have been seen for their second annual examination. Intervention results at 24 months are excellent. The mean diastolic blood pressure (DBP) for the S.I. group has decreased from a baseline of 91.1 to 82.4 mm Hg. Individuals who had a DBP z90 mm Hg. on two consecutive visits were considered hypertensive. Hypertension treatment included prescription of drug therapy (provided at no cost) and/or a weight reduction program. Of the 5,929 men examined at 24 months, 3,384 were previously classified as hypertensive by the above criteria. The drug therapy prescribed for 3,075 hypertensive men included: 96% on diuretics, 38% on reserpine, 14% on methyldopa, 6% on propranolol, 13% on hydralasine and less than 1% on quanethidine. Excluding hypokalemia and hyperurecemia there have been less than 350 reports of side effects. At the year two examination only 243 men previously classified as hypertensive had a DBP z95 mm Hg. Of these, 179 men were already prescribed antihypertensive drugs. 3.384 In an idealized model for hvuertension control. men are being treated with only 7%having DBP's >95 &*Hg. after participation in MRFIT for 2 years. It is clear that antihypertension therapy__ can be declared effective in a program with minimal side effects, normalization of DBP and low dropout rates. Time will tell whether antihypertensive therapy alters the rate of stroke and heart attack in this high risk group of men.
ABSTRACTS:
HIGH
BLOOD
PRESSURE
CONTROL
A-75
Whitney Evans, National Health Watch, Inc., 44132; Martin Saidlerrmn; Nonnan H. Daily
27801 Euclid
Avenue, Cleveland,
Ohio
In 1976, Health Watch developed and introduced a conprehensive Worksite hypertension control program to determine whether a private company could rrmnage and was to operate medically rrarket a financially viable program. Our objective sound and successful programs at revenue levels assuring sufficient funds to m years of experience resulted in attract qualified medical professionals. (1) medically successful programs with excellent patient acceptance, 9% control, with average diastolic pressures of 81.3; and (2) financial failure due to minimal employer acceptance of a cost effective program at less than $200 per Obstacles to employer acceptance have been reluctance to patient annually. sponsor "treatment" programs; unwillingness to spend today's dollars for prevention of future disability and death; lack of support in dmnstration programs and in llprbidity evaluations by health insurance companies; opposition by medical societies; and lack of federal funding directed toward alleviation We feel key obstacles can be overccme by (1) of the aforementioned obstacles. "seed rmney" from federal sources and insurance conpsnies for initiation of programs; (2) involvement of nationally known leaders in hypertension in explaining worksite program benefits to medical societies; and (3) conmitment to trial programs by medical directors of major American companies including the federal govenunent.
A-76 HYPERTENSIONCONTROLACHIEVEDBY MENRANDOMIZEDINTO THE SPECIAL INTERVENTION GROUPOF THE MULTIPLE RISK FACTORINTERVENTIONTRIAL AT TWENTY-FOUR MONTHS L. Falvo-Gerard, University of Pittsburgh, Graduate School of Public 130 DeSoto Street, Pittsburgh, Pennsylvania 15261; Lewis H. Kuller.
Health,
The Multiple Risk Factor Intervention Trial (MRFIT) provides an idealized model for hypertension control. Of the 6,428 men randomized into a special intervention (S.I.) group for cardiovascular risk factor reduction 92% have been seen for their second annual examination. Intervention results at 24 months are excellent. The mean diastolic blood pressure (DBP) for the S.I. group has decreased from a baseline of 91.1 to 82.4 mm Hg. Individuals who had a DBP z90 mm Hg. on two consecutive visits were considered hypertensive. Hypertension treatment included prescription of drug therapy (provided at no cost) and/or a weight reduction program. Of the 5,929 men examined at 24 months, 3,384 were previously classified as hypertensive by the above criteria. The drug therapy prescribed for 3,075 hypertensive men included: 96% on diuretics, 38% on reserpine, 14% on methyldopa, 6% on propranolol, 13% on hydralasine and less than 1% on quanethidine. Excluding hypokalemia and hyperurecemia there have been less than 350 reports of side effects. At the year two examination only 243 men previously classified as hypertensive had a DBP z95 mm Hg. Of these, 179 men were already prescribed antihypertensive drugs. 3.384 In an idealized model for hvuertension control. men are being treated with only 7%having DBP's >95 &*Hg. after participation in MRFIT for 2 years. It is clear that antihypertension therapy__ can be declared effective in a program with minimal side effects, normalization of DBP and low dropout rates. Time will tell whether antihypertensive therapy alters the rate of stroke and heart attack in this high risk group of men.