IDENTIFICATION OF ISOLATED HIGH BLOOD PRESSURE DURING WORK TIME, OPPORTUNE DIAGNOSTICS OF THE HYPERTENSIVE HEART DISEASE

Arterial hypertension (HTN) is the leading factor associated with myocardial infarction, stroke and premature death in the most countries. Annual prophylactic examinations in the organized populations aim at the HTN detection and related complications including the hypertensive heart disease (HHD). The isolated elevated blood pressure (BP) during work time (HTN at workplace, work-related HTN) is associated with the risk of HHD and other complications. The aim of our study was the assessment of work-related HTN prevalence and echocardiography (EchoCG) measures in the employees of the big industrial enterprise who were not treated with antihypertensive medications. Design and methods . This paper presents the results obtained from examination of workers not treated by the antihypertensive drugs (AHD) (n = 40). All subjects underwent physical examination, EchoCG, and 24-hour ambulatory BP monitoring (ABPM) Criteria of the work-related HTN were the combination of normal office BP level (< 140/90 mm Hg) and high BP (≥ 135 and/or 85 mm Hg) during the working hours (based on ABPM data within the period from 8 am till 5 pm). Results. Among 477 employees of the industrial enterprise, who underwent ABPM and EchoCG within the annual prophylactic examination, only 185 (39 %) had normal office BP levels. Among them only 40 persons (21,6 %) did not take AHD, and met other inclusion/exclusion criteria. Based on ABPM data, only 20 employees (50 %) had normal office and ambulatory BP levels. EchoCG showed a high rate (60 %) of the concentric left ventricular hypertrophy (LVH), other forms of heart remodeling (HHD) were rare, eccentric hypertrophy was found in 5 %, and concentric remodeling — in 15 %. The prevalence of left ventricular remodeling types was comparable to that in stable HTN. Conclusions . We believe that workrelated HTN is worth noting, in particular its early diagnosis and prevention is of great importance. ABPM at work place along with EchoCG for the detection of target organ damage should be included in the annual prophylactic examinations and will encourage the early diagnosis and timely cardiovascular prevention.