Employees at large companies could be at an increased risk of of serious medical conditions, according to a new study by IBM Watson and the American Heart Association (AHA) that found they are more susceptible to developing heart disease and stroke.

The study, published in Health Affairs, surveyed about 400,000 employees from 20 large organizations nationwide. Findings showed that because of seven major risk factors, individuals were at a higher risk of developing heart problems, suggesting that there is a need for more workplace health initiatives. The risk factors included high blood pressure, high cholesterol, high blood glucose, unhealthy weight, tobacco use, physical inactivity and poor diet, AHA said in a statement.

 “We Americans spend more than half of our waking hours at work,” said Ron Goetzel, PhD, an author on the study and a senior scientist at the John Hopkins Bloomberg School of Public Health and the vice president at IBM Watson Health, in a statement. “When they think about health, they don’t think of workplace as a place to get healthy. There are a lot of things employers could be doing to encourage healthy habits in the workplace.”

Study participants voluntarily completed health assessments, which shows that about 95 percent of employees had at least one of the seven major risks that contribute to heart disease and stroke.

Those factors increase employer medical spending by more than 200 percent per person every year. On a national level, heart disease and stroke cost the country $316 billion every year in health expenses and lost productivity, the study showed.

“These initial index findings are vital because employers want to better understand how their overall employee health compares to that of their peers, and they seek insights on which programs can yield the greatest benefit,” said Chris Calitz, an author on the study and the director of the AHA’s Center for Workplace Health Research and Evaluation, in a statement. “As we collect more data over time through AHA’s Index, this valuable insight will help inform the specific policies, programs and environmental factors that can best maintain and promote good heart health in the workplace.”

The authors hope the study influences employers to implement wellness programs in the workplace. It not only keeps employees healthier and happier, it boosts productivity.

“It goes beyond flu shots,” Goetzel said. “A wellness program has to be integrated into the company with senior management support.”