Documents hypertension 6 results

"Objective The effect of work on blood pressure (BP) in a general population with appropriate adjustment for confounders is not well defined. High job control has been found to be associated with lower BP and with nocturnal BP dipping. However, with older workers this may be compromised and has not been studied extensively.Methods A cross-sectional study was carried out on a primary care-based sample (N=2047) aged 50–69 years. Data were collected on sociodemographic factors, medication, clinic, and ambulatory blood pressure. Job control was measured using two scales from the Copenhagen Psychosocial Questionnaire (COPSOQ) (possibility for development and influence at work). Nocturnal systolic BP (SBP) dipping was the reduction in SBP from day- to night-time using ambulatory SBP readings.Results In general, BP increased with age, male gender, and higher body mass index. Workers with high influence at work and high possibility for development were more likely to have high asleep SBP [odds ratio (OR) 2.13, 95% confidence interval (95% CI) 1.05–4.34, P=0.04], (OR 2.27, 95% CI 1.11–4.66, P=0.03) respectively. Influence at work and awake BP were inversely associated: awake SBP (OR 2.44, 95% CI 1.35–4.41, P<0.01), awake DBP (OR 2.42, 95% CI 1.24–4.72, P=0.01). No association was seen between job control and nocturnal SBP dipping.Conclusion Older workers with high job control may be more at risk of cardiovascular disease resulting from high day- and night-time BP with no evidence of nocturnal dipping."

The aim of this study was to analyze the relationship of job strain (high psychological job demands and low decision latitude) to hypertension, serum lipids, and plasma fibrinogen.No strong associations were found between job strain and plasma fibrinogen. The males reporting job strain had lower levels of total cholesterol and high-density lipoprotein cholesterol than the other males. Similar tendencies were found for the females. The females, but not the males, with job strain had an increased prevalence of hypertension when compared with the subjects with relaxed psychosocial work characteristics. In the subgroups of younger males and females an adverse association between job strain and the ratio between low-density and high-density lipoprotein cholesterol was noted.The results do not support the hypothesis that job strain has an adverse impact on serum total cholesterol and plasma fibrinogen levels. They suggest that an increased risk of coronary heart disease in association with job strain, if causal, is mediated by other factors, possibly partly by hypertension and low levels of high-density lipoprotein cholesterol.

"Objectives The objective of this study was to analyze gender differences in the impact of long workhours (>40 hours per week) on a variety of health outcomes and health-related behavior.Methods The sample included all salaried contract workers aged 16–64 years (1658 men and 1134 women) and interviewed in the 2002 Catalonian Health Survey.Results Whereas the men with a high job status were more likely to work >40 hours a week, long workhours were associated with situations of vulnerability (low job status and being separated or divorced) among the women. For both genders, working >40 hours was related to a shortage of sleep [adjusted odds ratio (aOR) 1.54, 95% confidence interval (95% CI) 1.21–1.98, for the men and aOR 1.63, 95% CI 1.11–2.38, for the women]. Among the women, long workhours were also associated with poor mental health status (aOR 1.58, 95% CI 1.04–2.40), hypertension (aOR 2.25, 95% CI 1.17–4.32), job dissatisfaction (aOR 1.77, 95% CI 1.08–2.90), and smoking (aOR 1.71, 95% CI 1.22–2.39). In addition, among the women working more hours at home, long workhours were related to sedentary leisure time activity (aOR 1.98, 95% CI 1.06–3.71). Conclusions The relationship between long workhours and health and health-related behavior was found to be directly related to long worktime and indirectly related to long exposure to poor work conditions among the women and, to a less extent, to domestic work. The pathways that explain the relationship between long workhours and health and health-related behavior seems to depend on the outcome being analyzed."

"Objective Increased risk of ischemic heart disease (IHD) mortality from high physical work demands has been observed among men with low physical fitness and leisure time physical activity. We tested whether hypertensive men are at a particularly high risk of IHD mortality when exposed to high physical work demands. Method We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 gainfully employed men aged 40–59 years. Of these, 274 men with a history of myocardial infarction or prevalent symptoms of angina pectoris or intermittent claudication were excluded from the follow-up. Men were classified as having hypertension when any of the following factors was present: (i) treatment for hypertension, (ii) a systolic blood pressure of >160 mm Hg, or (iii) a diastolic blood pressure of >90 mm Hg. Physical work demands were determined by two self-reported questions. Results Of the eligible study population, 587 men (11.9%) died due to IHD. Hypertensive men had more than a doubled risk of IHD mortality [hazard ratio (HR) 2.16, 95% confidence interval (95% CI) 1.80–2.59]. Cox analyses – adjusted for age, smoking, alcohol, body mass index, diabetes, physical fitness, leisure time physical activity, and social class – showed that high physical work demands were associated with an increased risk of IHD and all-cause mortality among normotensive men (N=4127, HR 1.36, 95% CI 0.96–1.92 and HR 1.24, 95% CI 1.06–1.44, respectively), but not among the hypertensive men (N=808, HR 1.07, 95% CI 0.63–1.81 and HR 1.07, 95% CI 0.80–1.42, respectively) using men with low physical work demands as the reference. Conclusion Compared to normotensive men, hypertensive men did not have a higher risk of IHD or all-cause mortality from high physical work demands."

"Une maladie professionnelle engage la responsabilité de l'employeur. Elle ouvre sur un contentieux dans lequel l'arbitrage scientifique est attendu essentiellement de l'épidémiologie. Cet enjeu pèse sur la compréhension des liens entre santé et travail, car il focalise l'attention sur les relations causales simples et tend à laisser dans l'ombre les effets liés au contexte et à l'histoire. Nous présentons pourtant le cas d'une salariée qui illustre l'importance de ces dimensions. À la suite d'une exposition prolongée à un stress psychosocial et à de fortes contraintes gestuelles et posturales, elle a été traitée pour une hypertension artérielle, pour une dépression et pour une longue série de troubles musculo-squelettiques. Ce cas permet d'attirer l'attention sur le rôle central de l'inflammation et du stress oxydant, non seulement en matière de liens entre souffrance psychique et atteintes du corps mais, au-delà, pour la compréhension des interactions entre les différentes contraintes et nuisances du travail, agressions toxiques comprises."