S-23-3: EFFECT OF A WORKPLACE-BASED PRIMARY PREVENTION INTERVENTION FOR CARDIOVASCULAR DISEASE ON INCIDENCE OF HYPERTENSION - A CLUSTER RANDOMIZED CONTROLLED TRIAL

Abstract

Objective: A workplace-based primary prevention intervention for cardiovascular disease could be an effective approach to encourage employees to adopt a healthy lifestyle and control the occurrence of hypertension. Our objective is to assess the effect of a workplace-based, multicomponent primary intervention strategy for cardiovascular disease on controlling the incidence of hypertension. Methods: A cluster randomized clinical trial was conducted from January 2013 to December 2014 in 60 workplaces across 20 urban regions in China. Workplaces were randomized to either the intervention group (n = 40) or control group (n = 20). All employee participants in each workplace were asked to complete standard questionnaire surveys and physical examinations. Employees in the intervention group were given a two-year workplace wellness intervention program, while those in the control group only maintained the existing health management measures in the workplace and did not receive additional intervention. The incidence of hypertension in baseline non-hypertensive patients in the intervention and control groups, as well as changes in blood pressure levels and lifestyle factors were assessed at the end of the trial. Results: Overall, 21,667 participants (16,488 in the intervention group and 5,179 in the control group) were included (mean [SD] age, 39.2 [9.0] years; 13,207 men [61.0%]). After 24 months of the intervention, the incidence of hypertension in baseline non-hypertensive patients was 7.2% in the intervention group and 8.2% in the control group (RR = 0.88, 95% CI,0.79 to 0.98, P = 0.012). The intervention effect was significant on systolic BP level (beta = -0.42, 95% CI, -0.80 to -0.05; P = 0.027) and on diastolic BP level (beta = -0.37, 95% CI, -0.67 to -0.07; P = 0.014). Moreover, greater improvement was reported in healthy lifestyle, such as the rates of smoking (-1.6%; 95% CI, -2.5% to -0.6%; P < 0.001), drinking (-3.1%; 95% CI, -4.0% to -2.2%; P < 0.001), regular exercise (10.9%; 95% CI, 9.8% to 11.9%; P < 0.001), perceived stress (-5.7%; 95% CI, -6.6% to -4.7%; P = 0.025), fatty food intake (-9.0%; 95% CI, -10.1% to -7.9%; P < 0.001) and excessive use of salt (-5.5%; 95% CI, -6.3% to -4.6%; P < 0.001). Conclusion: This trial found that workplace-based primary prevention interventions for cardiovascular disease appeared to be effective in reducing the prevalence of hypertension, leading to measurable benefits such as lower blood pressure and adoption of healthy lifestyle habits. The intervention can therefore be considered for large-scale use or inclusion in workplaces health promotion programs in China and other countries.