March 21, 2018Open Access
View Full PaperStress management in the workplace for employees with hypertension: a randomized controlled trial
Key Result
A 10-week workplace stress management program significantly reduced systolic blood pressure by 7.5 mm Hg compared to enhanced usual care in employees with hypertension (p=0.04).
Study Design
Type
RCT (n=92)
Multicenter
No
Structured PICO
Does a 10-week workplace group workshop on cognitive-behavioral coping skills reduce blood pressure in urban medical center employees with hypertension compared to enhanced usual care?
P
Population
92 urban medical center employees with hypertension randomized to a 10-week cognitive-behavioral stress management program or enhanced usual care.
I
Intervention
10-week group workshop on cognitive-behavioral coping skills (standardized stress management program delivered in groups at the workplace)
C
Comparator
Enhanced usual care including self-help materials for BP reduction and physician referral
O
Outcome
Reduction in blood pressure (systolic and diastolic)surrogate
A 10-week workplace stress management program significantly reduced systolic blood pressure in employees with hypertension compared to enhanced usual care.
Main Result
Mean Difference: -7.5
p-value: p=0.04
Abstract
While behavioral interventions can improve blood pressure (BP) in individuals with hypertension, getting such services to people who could benefit remains difficult. Workplace programs have potential as dissemination vehicles. The objective is to evaluate the effectiveness of a standardized stress management program delivered in groups at the workplace for reducing BP compared with enhanced usual care. This randomized controlled trial studied 92 urban medical center employees with hypertension randomized into two groups. The intervention was a 10-week group workshop on cognitive-behavioral coping skills. Enhanced usual care included self-help materials for BP reduction and physician referral. Intervention group participants' systolic BP (SBP) decreased 7.5 mm Hg over controls between baseline and follow-up, from 149.1 (95% CI: 146.0-152.1) to 140.0 (95% CI: 134.7-145.2), p < .001. The differential change between intervention and enhanced usual care groups (Group × Time interaction) was 7.5 mm Hg (t = -2.05; p = .04). Diastolic BP reductions were not significantly different. Scores on measures of emotional exhaustion and depressive rumination showed significant improvements and correlated with reductions in SBP. There was no significant change in the usual care group. A standardized worksite group intervention produced clinically meaningful reductions in SBP in participants with hypertension.