Behavioural and psychosocial correlates of nondipping blood pressure pattern among middle-aged men and women at work

Abstract

The underlying pathogenetic mechanisms of nondipping blood pressure (BP) pattern are not completely understood. Especially the role of psychosocial correlates remains unclear. The aim was to assess the association between nondipping BP pattern, behavioural and psychosocial factors in a sample of working men and women. The study sample included 167 working men and women aged 40-64 years from the BELSTRESS cohort. Sociodemographic, behavioural and psychosocial factors were assessed by self-administered questionnaires. Participants were medically examined and underwent an ambulatory BP monitoring during 24 h. Nondipping was defined when the average nocturnal decline in BP was o10%. The prevalence of nondipping for both systolic and diastolic BP was 7.8%. Nondipping was not significantly related to smoking, alcohol consumption and leisure time physical activity. A crude significant association was observed between nondipping and sleep problems. After adjusting for gender, education and body mass index, the risk for nondipping was associated with job strain, living alone, being unsatisfied about the contact with one's children, depressive symptoms and vital exhaustion. Nondipping BP pattern was consistently related to psychosocial factors in this study: positive associations were observed with measures of job strain, poor private life support (living alone and being unsatisfied about the contact with one's children) and mental health problems (depressive symptoms and vital exhaustion).

The effect of job strain on nighttime blood pressure dipping among men and women with high blood pressure

“…Several studies (12, 13, 26, 27) have shown that blunted nighttime BP dipping, or non-dipping, is associated with end-organ damage, increased risk of future cardiovascular events and higher cardiovascular morbidity and mortality. One recent Belgian study suggests that job strain is an independent risk factor for non-dipping (14). Our study supports this possibility by demonstrating that men with high job strain had significantly blunted SBP and PP dipping compared to men with low job strain.…”

“…A number of studies have reported that hypertensive patients with a non-dipping BP pattern (<10% nighttime BP fall) show more end-organ damage and higher cardiovascular morbidity and mortality than those who show normal BP dipping (≥10% nighttime BP fall)(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.…”

Adverse effects of psychosocial work factors on blood pressure: systematic review of studies on demand–control–support and effort–reward imbalance models

“…Confounding might also be present in other studies due to a lack of control for cardiovascular risk factors. For example, some studies did not control for age (125,132,144,146,174) or family history of CVD (61 studies) (23, 44, 124-129, 131-141, 153, 155-159, 161-168, 171, 174, 178, 180, 181, 183, 185-189, 192-194, 214, 223, 224) (tables A-C), which constitute major risk factors for high BP. Residual confounding might also have resulted from the fact that none of the studies on job strain controlled for ERI or vice-versa.…”

Non-dipping nocturnal blood pressure and psychosis parameters in Parkinson disease

“…Furthermore, it has been suggested that non-dipping is also associated with other non-cardiovascular symptoms such as psychosocial factors. [11] Non-dipping is common in PD, and ranges in prevalence from 40% [12] to 92% [13]. The reasons for a blunted/reversed circadian blood pressure rhythm in PD can include several factors, including pathological entities, such as disorders of nocturnal movement, obstructive sleep apnea (OSAS), supine hypertension and reduced quality of sleep.…”