Neither Perceived Job Stress Nor Individual Cardiovascular Reactivity Predict High Blood Pressure

Abstract

Abstract-We have reported that high job strain was associated with a significantly higher diastolic blood pressure (DBP) of 4.5 mm Hg during the working hours, irrespective of BP reactivity to a stress test. We report the final results of the first 5-year follow-up study, which aimed to assess the respective influences of perception of professional strain and cardiovascular reactivity to a mental stress test on BP. A cohort of 292 healthy subjects (meanϮSEM age, 38Ϯ1 years) was followed up for progression to hypertension outcome, which was defined as an increase in systolic blood pressure (SBP) or DBP Ͼ7 mm Hg or a DBP Ͼ95 mm Hg during follow-up. None of the subjects was lost to follow-up, and 209 subjects completed the study. The high-strain (HS) group, representing 20.9% of the subjects, was compared with the remaining subjects (non-high-strain [NHS]). Similarly, the subjects with the highest BP stress reactivity (HR; 20.9% of subjects) were compared with the remaining subjects (NHR). Progression to hypertension was reached by 93 subjects (31.8%). Kaplan-Meier survival estimates revealed that neither HS nor HR increased the incidence of progression to hypertension. End-of-follow-up 24-hour ambulatory BPs that were similar in HS and NHS (120Ϯ2 vs 120Ϯ1 mm Hg, respectively) and in HR and NHR (122Ϯ2 vs 120Ϯ1 mm Hg, respectively) confirmed our findings. Age, alcohol, salt diet, body mass index, and occupation did not interfere with our results. In conclusion, cardiovascular HR and HS do not appear to be major risk markers for future high BP in healthy, young adults. Key Words: epidemiology Ⅲ stress Ⅲ clinical trials Ⅲ hypertension, essential Ⅲ blood pressure monitoring, ambulatory P sychological stress is hypothesized as 1 of the major environmental factors implicated in the genesis of hypertension. Among various psychological stresses, the most investigated has been job-related stress. It was defined by Karasek et al 1 as the combination of high psychological demand and low latitude on the job. To date, only 3 studies designed to assess the long-term effect of job strain on blood pressure (BP) have produced controversial results. 2-4 The most convincing 1 was a case-control study, which found that high job strain was associated with a 3-year increase in systolic BP (SBP)/diastolic BP (DBP) of 5/3 mm Hg, supporting the hypothesis that job strain might be an etiologic factor in the genesis of essential hypertension. 4 The effects of stressors on cardiovascular regulation involve 2 components that have never been studied concomitantly. The first component is individual stress perception, quantified by questionnaires, and the second is individual cardiovascular reactivity to stress, assessed by a BP surge in response to stress tests. We recently reported the results of a cross-sectional analysis 5 of a prospective study in which subjective perception of job strain was evaluated by the questionnaire developed by Karasek et al, 1 and stress cardiovascular reactivity was measured by the Stroop stress test. The main re...

Job Strain, Ethnicity, and Sympathetic Nervous System Activity

“…Although some researchers have found an association between job strain and the development of hypertension in longitudinal studies, 42 others have not found such an association. 41 Our results show that high job strain is associated with increased BP reactivity to an alpha agonist. This supports the results of a study conducted by Steptoe et al 43 in which individuals with high job strain had greater BP reactivity to behavioral stress than those with low job strain.…”

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

“…Number of studies reporting a statistically significant deleterious effect / total number of studies having these methodological characteristics (reference number) reporting a deleterious effect of the demand-control-support factors on blood pressure according to study designs (cross-sectional, prospective or case-control), blood pressure (BP) measurements (office or ambulatory), and outcome (hypertension or BP level). (23,142,148,154) 0 / 1 (137) 1 (163) /1 (163) 1 (167) (142,148,161,180) 4 (155,166,176,182) / 5 (137,155,166,176,182) 0 /0 1 (167) / 1 (167) 21 / 40 a Studies on both BP level and hypertension (137,147,158,162,167). b Two studies also reported a significant protective effect of job strain (131,157).…”

“…However, creating prospective cohorts free of the outcome under study at baseline is an important methodological quality since it allows causal inferences to be made by ensuring that the exposure precedes the outcome. In keeping this rationale, most prospective studies on hypertension (4/6 studies) opted to exclude hypertensive workers at baseline (137,142,154,191) …”

“…Only 7 (137,150,151,154,166,182,191) of 64 studies evaluated the effect of job strain or ERI using more than a single time-point. Of these, 5 observed a significant adverse effect, which is a higher proportion than that observed in studies using a single time-point exposure (28/57 studies, table A).…”

Knowledge and prevalence of risk factors for arterial hypertension and blood pressure pattern among bankers and traffic wardens in Ilorin, Nigeria

“…3 Hypertension is now a burden to the society and several modifiable risk factors contribute directly to this burden. 4 High job strain has been associated with significantly higher diastolic blood pressure of 4.5mmHg during working hours 5 and it has been proven that chefs showed one risk factor more than office workers. 6 There is also a dearth of information on diet related chronic diseases in West Africa creating a challenge for comparative research for intervention purposes.…”