Influence of socioprofessional conditions on blood pressure levels and hypertension control. Epidemiologic study of 6,665 subjects in the Paris district.

A total of 6,665 subjects (3,896 men and 2,769 women) employed by small and medium-sized companies in the Paris region were examined. Mean systolic blood pressure (SBP) was significantly higher in the lowest than in the highest occupational categories (p less than 0.001), even when results were adjusted for age (p less than 0.001) and body mass index (p less than 0.001). Diastolic blood pressure (DBP) differed among the occupational categories (p less than 0.001); the differences were still significant after adjustment for age but not for body mass index, suggesting that the latter might be partly responsible for the differences in DBP. Prevalence of hypertension was 14.7% and was negatively associated with a high occupational category (p less than 0.001). Multivariate analysis confirmed the influence of occupational category on SBP (p less than 0.001). Exposure to noise at work and assembly line work were associated with high SBP (p less than 0.01 for both). Of the subjects with detected hypertension, 65.6% were aware of their illness, and 35.3% were undergoing treatment. Both the percentage of treated patients and compliance with treatment were positively associated with occupational category (p less than 0.01 in both cases). Among women, SBP of treated hypertensives was higher in the lowest than in the highest occupational categories (p less than 0.05). It is suggested that the differences in blood pressure levels observed among occupational categories are partly due to working conditions, and that poor compliance with treatment among the low occupational categories enhances these differences.