Improvement of the risk management system due to arterial hypertension in industrial enterprises

• Dmitriy S. Medvedev
• Artur M. Tuktarov
• Alexandra А. Shutovich
• Anna K. Ozornina
• Andrey G. Obrezan

Abstract

Background. Prevention of the development of cardiovascular diseases is an important task of preventive medicine, especially in people of working age. Corporate methods of workplace health management are increasingly being implemented.

The purpose of this study was to estimate the methods of screening and additional examination of workers with high risks due to hypertension at the health center level.

Material and methods. This work is a prospective, epidemiological study of employees of an industrial enterprise. As part of the pretrip examination, all patients were performed with the help of ESMO (Electronic medical examination system, Kvazar production, Russia). Patients were divided into 3 groups depending on the blood pressure level according to ESMO data: group 1 – ​more than 140/90 mm Hg (n=87), group 2–130–139/85–89 mm Hg (n=15), group 3 – ​less than 130/85 mm Hg (n=18).

Results. In group 1 and group 2, compared with normotonics, risk factors such as smoking, insufficient physical activity, poor nutrition, overweight and abdominal obesity were more common. Hypercholesterolemia (total cholesterol ≥5.0 mmol/l) in the group with hypertension occurred in every second, and fasting hyperglycemia (≥6.1 mmol/l) in 10% of the surveyed in this group, while in groups 2 and 3 this risk factor was not detected. The increased Cornell voltage index in the group with elevated blood pressure was detected in 83% of patients and was significantly higher than in the groups with highly normal and normal blood pressure (13.2 and 3.8%, respectively, p<0.005). The increased Sokolov–Lyon index was also significantly higher in group 1 compared with the group of highly normal blood pressure (86.5 and 13.5%, respectively, p<0.005), and was not recorded in the control group. Univariate linear regression analysis showed a positive relationship between ESMO blood pressure and age, body mass index and Cornell voltage index.

Conclusion. The conducted research made it possible to evaluate additional possibilities of using ESMO in order to detect hypertension. The results indicate that if more than 20% of blood pressure measurements are detected during the month, more than 140/90 mmHg should be referred a cardiological examination. It should also be noted about the high prevalence of such diseases as smoking, low physical activity, poor nutrition, hyperglycemia and obesity, which should be taken into account when developing preventive programs aimed at preventing the risk of developing atherosclerotic cardiovascular diseases in the surveyed contingent.

Keywords: cardiovascular diseases; arterial hypertension; risk factors; preventive medicine

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