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Working conditions and masked hypertension.

Authors
Landsbergis-PA; Travis-A; Schnall-PL
Source
High Blood Press Cardiovasc Prev 2013 Jun; 20(2):69-76
NIOSHTIC No.
20043792
Abstract
INTRODUCTION: Masked hypertension, i.e., normal clinic blood pressure but elevated blood pressure during normal daily activities as measured by ambulatory monitoring, is a common problem and a serious cardiovascular risk factor. Given previously reported associations between work stressors and ambulatory blood pressure, an inquiry into the relationship between work stressors and masked hypertension is warranted. OBJECTIVE: To assess the relationship between working conditions and masked hypertension. DESIGN: Cross-sectional study. SETTING: Hospital and home care employers in New York City. STUDY PARTICIPANTS: Forty-five male and 119 female hospital and home care employee volunteers wore an ambulatory blood pressure monitor during working hours. MAIN OUTCOME MEASURES: Masked hypertension was defined as work systolic ambulatory blood pressure =135 mmHg or diastolic ambulatory blood pressure =85 mmHg, and casual blood pressure <140/90 mmHg with no use of antihypertensive medications. Associations between work stressors and masked hypertension were tested by multiple logistic regression. RESULTS: Masked hypertension, observed in 24.0% of males and 17.6% of females with normal casual office obtained blood pressure, was associated with evening, night or rotating shiftwork (odds ratio (OR) 8.25, 95% confidence interval (CI) 2.11-40.31) and with the combination of job strain and effort-reward imbalance (OR 2.97, 95% CI 1.02-8.60) after controlling for age. Associations remained substantial, and statistically significant for shiftwork, after individual adjustment for each of 10 potential confounders. Masked hypertension was not associated with total weekly work hours. CONCLUSIONS: Masked hypertension is a significant individual and public health concern. Additional research is needed to clarify the role of work-related risk factors in the development of masked hypertension, and to develop an appropriate clinical and public health strategy for diagnosis, treatment and prevention.
Keywords
Humans; Health-care-personnel; Work-environment; Work-operations; Work-organization; Medical-monitoring; Blood-pressure; Hypertension; Risk-factors; Cardiovascular-function; Cardiovascular-system; Job-stress; Stress; Men; Women; Monitors; Systolic-pressure; Mathematical-models; Public-health; Shift-work; Author Keywords: Job stress; Job strain; Effort-reward imbalance; Shiftwork; Work hours; Masked hypertension; Ambulatory blood pressure
Contact
Paul Landsbergis, Department of Environmental and Occupational Health Sciences, State University of New York-Downstate School of Public Health, 450 Clarkson Ave., Box 43, Brooklyn, NY 11203, USA.
Publication Date
20130601
Document Type
Journal Article
Email Address
paul.landsbergis@downstate.edu
Funding Type
Grant
Fiscal Year
2013
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-007577
Issue of Publication
2
ISSN
1120-9879
Source Name
High Blood Pressure & Cardiovascular Prevention
State
NY; CA
Performing Organization
Mount Sinai School of Medicine
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