Increased Absenteeism from Work after Detection and Labeling of Hypertensive Patients

A study of hypertension in an industrial setting allowed us to confirm and explore an earlier retrospective finding that the labeling of patients as hypertensive resulted in increased absenteeism from work. After screening and referral, we found that absenteeism rose (mean ±1 S.E.) 5.2±2.3 days per year (P<0.025); this 80 per cent increase greatly exceeded the 9 per cent rise in absenteeism in the general employee population during this period. The main factors associated with increased absenteeism were becoming aware of the condition (P<0.01) and low compliance with treatment (P<0.001). Subsequent absenteeism among patients unaware of their hypertension before screening was not related to the degree of hypertension, whether the worker was started on therapy, the degree of blood-pressure control achieved or exposure to attempts to promote compliance. These results have major implications for hypertension screening programs, especially since absenteeism rose among those previously unaware of their condition, regardless of whether antihypertensive therapy was begun. (N Engl J Med 299:741–744, 1978) THE rationale for the detection and treatment of hypertension is the expectation that, in the long run, these steps will reduce premature morbidity and untimely death. One comprehensive detection and treatment program has, in fact, documented a reduction in “disability days” (absences from work of five or more days) among hypertensive employees of a department store.1 On the other hand, a recent United States survey reported twice as many days away from work or usual activities among employees who were aware of their hypertension as among those who either were normotensive or were unaware that they had hypertension,2 and a. © 1978, Massachusetts Medical Society. All rights reserved.