Hypertension is unrecognized in more than half of hypertensive patients in recent studies. It is characterized by an exceptionally high prevalence among young adults [1, 2].

To encourage untreated hypertensive patients to visit a hospital, approaches that increase awareness, simplify access, and involve multidisciplinary care teams have proven effective [3].

Health administrators (Has) support such initiatives by streamlining resources, ensuring accessibility, and implementing policy changes. Studies have shown that integrated healthcare systems, which include administrators coordinating various healthcare services, improve hypertension outcomes by reducing barriers to care, such as the cost and availability of services [4, 5]. This coordinated approach, often involving nurses and pharmacists, has effectively lowered blood pressure levels through consistent follow-up and patient engagement programs.

This research assesses whether the presence of HAs—who are often not licensed health professionals—encourages employees with newly identified hypertension to seek medical follow-up. This study holds particular significance as healthcare resources in smaller companies are typically limited, and employees may lack structured support for managing chronic health conditions. The study population included 72,539 employees across 5908 companies, with participants grouped based on the presence or absence of an HA at their worksite. Analyses were conducted separately for hypertensive and non-hypertensive individuals, with a particular focus on newly identified hypertensive cases. HAs were identified as individuals who help facilitate the connection between identifying hypertension during regular health checkups and ensuring employees seek timely treatment. These roles were filled by employers, non-licensed clerical staff, or licensed medical professionals, highlighting a flexible approach to healthcare administration in resource-limited settings.

In terms of hypertension prevalence and blood pressure management, no significant difference emerged between companies with and without an HA regarding hypertension rates or antihypertensive treatment uptake. However, companies with HAs showed a slightly higher representation of female employees and a modest reduction in systolic blood pressure (SBP). These findings suggest that the presence of an HA may contribute to a marginal improvement in workplace health outcomes, though the overall effect on hypertension prevalence remains limited. For employees newly diagnosed with hypertension, the presence of a health administrator(HA) was linked to a higher likelihood of visiting medical facilities within the first month following their health checkup. The adjusted odds ratio (OR) for this association was 1.74, compared to employees in companies without an HA. This effect was especially significant for employees with more severe hypertension, defined as a systolic blood pressure (SBP) of ≥150 mmHg or a diastolic blood pressure (DBP) of ≥95 mmHg, where the adjusted OR increased to 3.05. By the second month, the impact of HAs on follow-up visits diminished, with the adjusted OR approaching 1.0, indicating that the HA’s influence was most substantial immediately following the health screening.

This study builds on previous research by demonstrating that even non-licensed HAs can positively impact healthcare follow-up actions for hypertension, a role previously associated primarily with licensed health professionals in larger workplaces [6]. The findings underscore the potential for non-licensed staff, when designated as HAs, to effectively promote healthcare engagement, suggesting that a formal medical background is not always necessary for encouraging adherence to medical recommendations in small workplace settings.

Managing hypertension effectively is crucial, and non-professional interventions have been explored as a cost-effective and accessible approach to improve hypertension outcomes. Recent advancements in hypertension management have emphasized the use of digital health tools, telemonitoring [7, 8], which offer new insights and potential enhancements to traditional models involving healthcare administrators. Digital technologies, such as telemonitoring for blood pressure, have shown significant promise in improving patient adherence and outcomes, mainly through increased patient self-awareness and ongoing tracking, which could complement the role of healthcare administrators in workplaces.

Additionally, workplace interventions combining health education, diet, and physical activity components are shown to reduce hypertension, especially in high-risk populations effectively [9]. This holistic approach aligns with findings from newer workplace programs focused on cardiovascular health, prioritizing behavioral and lifestyle interventions over-relying on occasional health checkups alone.

Overall, this study highlights the potential for HAs, including non-licensed staff, to support hypertension management in small-to-medium-sized workplaces by encouraging timely medical follow-up. The results advocate for workplace health initiatives to incorporate roles that facilitate healthcare guidance, particularly in resource-limited settings. Such initiatives could be especially beneficial in regions with high rates of undiagnosed or untreated hypertension, particularly in parts of Asia where workplace health checkups are not as systematically implemented. By increasing early adherence to medical advice, HAs may contribute to improved hypertension management and, ultimately, to better health outcomes in workplace settings where healthcare resources are constrained (Fig. 1).

Worksite Health Administrators Associated with Increased Early Hypertension Treatment Visits