SMALL, BLUE-COLLAR WORK-SITE HYPERTENSION SCREENING - A COST-EFFECTIVENESS STUDY

This study determined the cost-effectiveness of one- versus two-stage hypertension screening at small to medium-sized blue collar, multicult ural work,sites using voluntary health organization and public health unit personnel. Workers with diastolic blood pressure (DBP) greater-th an-or-equal-to 90 mm Hg were randomly allocated to one- or two-stage s creening with differing physician referral protocols based on blood pr essure level and treatment status. At first screening of 7856 workers, 12.5% had DBP greater-than-or-equal-to 90 mm Hg or <90 and on medicat ion with 64% aware of having hypertension, 42% on medication and 30% c ontrolled (DBP <90 mm Hg). One year later, there were no significant d ifferences in effects or cost-effectiveness between groups. Both had s ignificant DBP decrease (8.5 mm Hg), 54% had seen a physician within t he recommended time, and 50% were controlled on medication or any trea tment. One-stage screening, being easier to implement, is the preferre d option.