Hypertension Screening of Commercial Divers from an Occupational Medicine Perspective
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Hypertension is one of the most common chronic diseases in the world: in the US, it affects one third of the adult population. Most cases are primary hypertension - with no identified cause - and significantly increase the risk for cardiovascular disease and stroke. At NASA's Neutral Buoyancy Laboratory (NBL), there is a cadre of professional divers who provide underwater support during extravehicular activity training (EVAs, commonly referred to as 'Spacewalks') for astronauts. The NBL occupational health program requires regular "work-site" physical exams, including blood pressure checks, on at least a weekly basis. Although some blood pressures measured during such regular checks were elevated, the diagnosis and management of blood pressure was outside the scope of that occupational medicine program. As a result, there was no protocol to analyze and manage asymptomatic elevated blood pressure if and when it warranted physician follow up. We therefore analyzed the blood pressure data from all divers in 2015, vetted the worksite physical and developed a referral pathway to ensure divers have access to effective management of their blood pressure while minimizing impact of such a program on daily operations.