Discussion
HTN, stroke, CVD, familial aggregation, coronary heart disease
CVD, STROKE, HTN, EVENTS, CORONARY HEART DISEASE
In this cluster randomized controlled study with a workplace-based primary prevention interventions program of CVD, we found that a multicomponent intervention in employees with primary care in workplace significantly reduced the incidence of HTN and improved the level of BP and healthy lifestyle habits at 24 months, compared to usual care. Our study may help other workplaces with similar conditions, in domestic or foreign, to design or conduct their workplace wellness plan for improving employees’ CVD health.Although some studies have focused on the effect of workplace health promotion on BP, few studies looked at the entire employees, let alone the incidence of HTN. We have seen a significant reduction in the incidence of HTN, which may be attributed to positive improvements in healthy lifestyles, because we found that people with deteriorating lifestyles had higher rates of developing HTN than those with an improved or same lifestyle before and after the intervention. The effects of reducing the incidence of HTN were significant across different characteristics of the occupational population and were most significant in those with a family history of CVD, which was consistent with previous findings that familial aggregation of CVD and its role as an independent risk factor for CVD is well recognized [Moreover, we saw significant differences in BP levels. Results from a meta-analysis of 147 randomized trials showed there was a 22% reduction in coronary heart disease events and a 41% reduction in stroke for a BP reduction of 10 mm Hg systolic or 5 mm Hg diastolic [In addition, we saw the significant intervention effects on lifestyles, such as the reduced rates of excessive intake of fatty food, restrictive use of salt, and the increased rate of regular exercise. Systematic reviews of workplace interventions have shown that a multicomponent intervention would result in significant and positive changes in behaviors [In our study, the intervention effect of BP was more pronounced among those with higher educational attainment. The studies found that the lower the educational attainment, the lower the level of health literacy [Recently published guidelines have highlighted the importance of focusing on lifestyle interventions and risk factor prevention and control [