Academic journal article Scandinavian Journal of Work, Environment & Health

The Effect of Job Strain on Nighttime Blood Pressure Dipping among Men and Women with High Blood Pressure

Academic journal article Scandinavian Journal of Work, Environment & Health

The Effect of Job Strain on Nighttime Blood Pressure Dipping among Men and Women with High Blood Pressure

Article excerpt

Objective Blunted nighttime blood pressure dipping is an established cardiovascular risk factor. This study examined the effect of job strain on nighttime blood pressure dipping among men and women with high blood pressure.

Methods The sample consisted of 1 22 blue- and white-collar workers (men=72, women=50). The Job Content Questionnaire was used to measure job psychological demands, job control, and social support. The ratio of job demands to job control was used to assess job strain. Nighttime blood pressure dipping was evaluated from 24-hour ambulatory blood pressure monitoring performed on three workdays.

Results Men with high job strain had a 5.4 mm Hg higher sleep systolic blood pressure (P=0.03) and 3.5 mm Hg higher sleep pulse pressure (P=0.02) compared to men with low job strain. Men with high job strain had a smaller fall in systolic blood pressure and pulse pressure from awake to sleep state than those with low job strain (P<0.05). Hierarchical analyses showed that job strain was an independent determinant of systolic blood pressure dipping (P=0.03) among men after adjusting for ethnicity, body mass index, anxiety and depression symptoms, current smoking status, and alcohol consumption. Further exploratory analyses indicated that job control was the salient component of job strain associated with blood pressure dipping (P=0.03).

Conclusions High job strain is associated with a blunting of the normal diurnal variation in blood pressure and pulse pressure, which may contribute to the relationship between job strain and cardiovascular disease.

Key terms ambulatory blood pressure; cardiovascular disease; diurnal variation; hypertension; pulse pressure.

Growing evidence indicates that job strain is an independent risk factor for hypertension (1^4). In terms of the etiology of hypertension, job strain is conceived as a chronic stressor that contributes to a progressive rise in blood pressure (BP). Using ambulatory blood pressure monitoring (ABPM), employees with high job strain have been observed to have higher BP at home and during sleep, as well as at work (5-10). The relationship of work stress and high ambulatory blood pressure (ABP) has been documented utilizing the demand-control or effort-reward imbalance model, which are the two contemporary approaches to assessing work related stress (11). Job strain was associated with elevated BP during sleep, implying the possibility that job strain may impact the circadian rhythm of BP (5). A blunting of the normal diurnal BP variation, or "non-dipping" of nighttime BP, is a risk factor for cardiovascular disease. A number of studies have reported that hypertensive patients with a non-dipping BP pattern (<10% fall in nighttime BP) show more end-organ damage and higher cardiovascular morbidity and mortality than those who show normal BP dipping (>10% fall in nighttime BP) (12, 13). However, there are few studies that have explored the relationship between job strain and blunted nighttime BP dipping (14, 15). The present study was designed to evaluate the impact of job strain on nighttime BP dipping in a study sample of untreated men and women with high normal or mildly elevated BP. In addition, gender was examined as a potential moderator of the effects of job strain on nighttime BP dipping because previous studies have shown that job strain tends to elevate BP among men rather than women (1, 16-18).

Methods

Study design and participants

This report provides a secondary analysis of a study designed to explore the causes and consequences of nighttime BP dipping. Participants were recruited from newspaper, television advertisements, and posting of study brochures in hypertension clinics and primary healthcare offices in the hospitals of piedmont region of North Carolina. Advertisements and brochures sought volunteers with high blood pressure to participate in a research study of 24-hour ABPM. No information about the plan to evaluate job strain was mentioned prior to enrollment. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.