Maritime Health Research and Education-NET/Early diagnostics of hypertension via routine medical exams

Goals

 * 1) Highly sensitive blood pressure measurements to give precise prevalence rates of hypertension and pre-hypertension in the target groups.
 * 2) Systematisation and centralisation of the results of the mandatory medical examinations.
 * 3) Epidemiological based prevention trials

Study design
Cross-sectional clinical study using data collected in private health clinics and public health-clinics (supplemental ambulatories)

Time frame for data collection
Data are collected from xxx to xxxx. The data collection stops when xxx participants is included.

Inclusion criteria

 * 1) All transport workers, seafarers, and fishermen, coming to routine health examinations are included in a given time period.
 * 2) Participants are invited randomly irrespective of risk status, for example, not only those with visible higher risk status for example with obesity.
 * 3) Retrospective random samples of medical records for 1/2  year for all, with inclusion of all coming to medical examination without any selection due to risk status
 * 4) Those with normal pressure in the test are included as positive hypertension if they have answered "yes" having hypertension in the interview scheme.
 * 5) To get unbiased samples of prevalence data, then all seafarers/fishers/transport workers coming for routine medical examination must be included in the study irrespective of their (visible) risk (while daily practice is something else) The study example below shows that if only those at higher risk (obesity and overweight) are included, then pre- and hypertension prevalence results will be biased to higher prevalences like 20.0% and 33.4% in these IMC groups respectively.

Demographics Clinic name, age, gender, seafarer, fisherman, nationality.

Laboratory data
Together with the diabetes data. Blood pressure, height in cm and weight in kg

Diagnostics
The valid clinical monitoring of hypertension the target group is the basis for an effective, evidence-based intervention plan.

Classification and automatic coding is under development

https://www.excelforum.com/excel-general/776923-how-to-categorize-blood-pressure-readings-into-groups.html

Inform seafarer whether (s)he is Non-diabetic, Pre-diabetec or Diabetic give advice and refer to specialist, if needed

Inform seafarer whether: non-hypertensive/pre-hypertensive/ hypertensive (see definitions), give advice and refer to hypertensive specialist if needed.

Use standardized reporting for research purposes, send data to designated international researcher contact (MAHRE-Net)

Prevention
Simple lifestyle measures have been shown to be effective in preventing or delaying the onset of type 2 diabetes. To help prevent hypertension and its complications, people should:
 * 1) Achieve and maintain healthy body weight
 * 2) Physically active – doing at least 30 minutes of regular, moderate-intensity activity on most days. More activity is required for weight control
 * 3) Eat a healthy diet, avoiding sugar and saturated fats; and
 * 4) Avoid tobacco use – smoking increases the risk of diabetes and cardiovascular disease

Intervention with the shareholders
Information and training is needed for the shareholders on how to take care to keep the workers with hypertension and diabetes in their job position. The shareholders in the respective job groups need to have knowledge to establish the needed specific conditions available for keeping good health practices for employees with T2DM and hypertension in the job. This in order to have good opportunities during the working day to have time and allowance for relevant work breaks, restroom visits, access to healthy meals in a good social company, and possibilities for adequate physical activities. These conditions are different for each job group and the analysis of these conditions and suggestions on how it can be made optimal is part of the project. Installations for the adequate structural change in the workplaces, time for meal breaks and restroom visits, cooks are hired to make healthy lunches, fitness room, and other relevant installations.

Ethics for protection of personal data
Confidentiality in the handling of personal data is in accordance with the rules of the national data protection agencies and the General Data Protection Regulation (GDPR) and is prepared with. No personally sensitive information is included in the data set given to the researchers, so approval from the Ethics Committee is not necessary. All questionnaires ask for informed consent as the first question.

TABLE 2. MAHRE-Net Hypertension draft research- and education plan

References