Xavier Trudel1, Chantal Brisson1, Alain Milot2, Benoit Masse3, Michel Vézina4. 1. Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Québec, Canada Département de médecine sociale et préventive, Université Laval, Québec, Canada. 2. Département de médecine, Université Laval, Québec, Canada. 3. École de Santé Publique, Université de Montréal, Montréal, Canada Centre de recherche, CHU Sainte-Justine, Montréal, Canada. 4. Département de médecine sociale et préventive, Université Laval, Québec, Canada.
Abstract
BACKGROUND: Two main theoretical models have been used to assess the impact of psychosocial work factors on blood pressure (BP): the demand-control (DC) model and the effort-reward imbalance (ERI) model. Previous studies have mostly used a single time point exposure to examine this association. OBJECTIVE: To examine the effect of repeated job strain and ERI exposure on (1) ambulatory BP (ABP) evolution over 5 years and (2) hypertension incidence over 5 years. METHOD: The design is a prospective cohort study. The study population was composed of 1394 white-collar workers (568 men and 826 women). They were assessed three times during a 5-year period (years 1, 3 and 5). At each time, psychosocial work factors were measured using validated scales and ABP was measured every 15 min during a working day. RESULTS: Men who were chronically exposed over 5 years to an active job had a higher cumulative incidence of hypertension (RR=2.05, 95% CI 1.36 to 3.09), compared with never-exposed men. In women, ERI exposure onset was associated with higher increases in systolic ABP (+2.5 mm Hg). No association was found between chronic high-strain exposure and ABP. CONCLUSIONS: Chronic exposure to active jobs in men led to a higher risk of hypertension and ERI exposure onset in women led to increases in systolic ABP. Results from the present study highlight the need to consider chronic exposure in order to fully capture the deleterious effect of adverse psychosocial work stressors on cardiovascular health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
BACKGROUND: Two main theoretical models have been used to assess the impact of psychosocial work factors on blood pressure (BP): the demand-control (DC) model and the effort-reward imbalance (ERI) model. Previous studies have mostly used a single time point exposure to examine this association. OBJECTIVE: To examine the effect of repeated job strain and ERI exposure on (1) ambulatory BP (ABP) evolution over 5 years and (2) hypertension incidence over 5 years. METHOD: The design is a prospective cohort study. The study population was composed of 1394 white-collar workers (568 men and 826 women). They were assessed three times during a 5-year period (years 1, 3 and 5). At each time, psychosocial work factors were measured using validated scales and ABP was measured every 15 min during a working day. RESULTS:Men who were chronically exposed over 5 years to an active job had a higher cumulative incidence of hypertension (RR=2.05, 95% CI 1.36 to 3.09), compared with never-exposed men. In women, ERI exposure onset was associated with higher increases in systolic ABP (+2.5 mm Hg). No association was found between chronic high-strain exposure and ABP. CONCLUSIONS: Chronic exposure to active jobs in men led to a higher risk of hypertension and ERI exposure onset in women led to increases in systolic ABP. Results from the present study highlight the need to consider chronic exposure in order to fully capture the deleterious effect of adverse psychosocial work stressors on cardiovascular health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Entities:
Keywords:
BLOOD PRESSURE; HYPERTENSION; OCCUPATIONAL HEALTH; Work stress
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