Prospective Surveillance of Hypertension in Firefighters

Authors

  • Elpidoforos S. Soteriades MD, MSc,

    1. From Cambridge Hospital, Harvard Medical School, Cambridge, MA;1Harvard School of Public Health, Department of Environmental Health (Occupational Health Program), Boston, MA;2Massachusetts General Hospital, Pulmonary/Critical Care Unit, Harvard Medical School, Boston, MA;3 and the Center for Occupational and Environmental Medicine, Northeast Specialty Hospital, Braintree, MA4
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  • 1,2 Stefanos N. Kales MD, MPH,

    1. From Cambridge Hospital, Harvard Medical School, Cambridge, MA;1Harvard School of Public Health, Department of Environmental Health (Occupational Health Program), Boston, MA;2Massachusetts General Hospital, Pulmonary/Critical Care Unit, Harvard Medical School, Boston, MA;3 and the Center for Occupational and Environmental Medicine, Northeast Specialty Hospital, Braintree, MA4
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  • 1,2 Dimitrios Liarokapis PhD,

    1. From Cambridge Hospital, Harvard Medical School, Cambridge, MA;1Harvard School of Public Health, Department of Environmental Health (Occupational Health Program), Boston, MA;2Massachusetts General Hospital, Pulmonary/Critical Care Unit, Harvard Medical School, Boston, MA;3 and the Center for Occupational and Environmental Medicine, Northeast Specialty Hospital, Braintree, MA4
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  • and 2,3,4 David C. Christiani MD, MPH, MS

    1. From Cambridge Hospital, Harvard Medical School, Cambridge, MA;1Harvard School of Public Health, Department of Environmental Health (Occupational Health Program), Boston, MA;2Massachusetts General Hospital, Pulmonary/Critical Care Unit, Harvard Medical School, Boston, MA;3 and the Center for Occupational and Environmental Medicine, Northeast Specialty Hospital, Braintree, MA4
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Stefanos N. Kales, MD, MPH, The Cambridge Hospital Department of Medicine, Occupational and Environmental Health, 1493 Cambridge Street, Cambridge, MA 02139
E-mail: stefokali@aol.com

Abstract

The authors evaluated blood pressure and antihypertensive medication use in 334 firefighters in an occupational medical surveillance program. Firefighters received written summaries of their examination results, including blood pressures, and were encouraged to see their personal physicians for any abnormal results. The mean age of the participants was 39 years, and the vast majority were men (n=330). The prevalence of hypertension was 20% at baseline (1996), 23% in 1998, and 23% in 2000. Among firefighters with high blood pressure readings, only 17%, 25%, and 22% were taking antihypertensive medications at the baseline, 1998, and 2000 examinations, respectively. Medical surveillance was effective in detecting hypertension in firefighters; however, after 4 years of follow-up, only 42% of hypertensives were receiving treatment with medications, including only 22% of firefighters with hypertensive readings. Overall, 74% of hypertensives were not adequately controlled. Possible reasons for low treatment rates may be the inadequate recognition among primary care physicians that mild hypertension is a significant risk factor for cardiovascular disease.

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