Blood pressure and fitness for work.

A survey was carried out to determine whether physicians in Occupational Medicine exclude job applicants because of hypertension and to examine the critical blood pressure cut-off values they apply. The survey sampled 116 respondents, members of the American Occupational Medical Association, Central States. Of these, 33 (28%) reported excluding hypertensives from work permanently, as the policy of one or more of the companies they serve. Another 78 physicians (68%) reported excluding hypertensives permanently on their own initiative when there was no company policy. The critical determining diastolic pressure varied from 90 to greater than 130 mm Hg; 22 respondents (19%) excluded individuals with mild hypertension. The results demonstrate that blood pressure is frequently used as a criterion for employment. Additionally, the level of blood pressure precluding work is arbitrary and variable. There is a need for consensus on appropriate guidelines to preclude inappropriate discrimination against hypertensive job applicants.