학술논문

Working Conditions and Masked Hypertension.
Document Type
Article
Source
High Blood Pressure & Cardiovascular Prevention. 2013, Vol. 20 Issue 2, p69-76. 8p.
Subject
*ACADEMIC medical centers
*AMBULATORY blood pressure monitoring
*CHI-squared test
*CONFIDENCE intervals
*EPIDEMIOLOGY
*HYPERTENSION
*MULTIVARIATE analysis
*PATIENT monitoring
*QUESTIONNAIRES
*RESEARCH funding
*STATISTICS
*PSYCHOLOGICAL stress
*WORK environment
*EMPLOYEES' workload
*LOGISTIC regression analysis
*DATA analysis
*DATA analysis software
*DESCRIPTIVE statistics
Language
ISSN
1120-9879
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. [ABSTRACT FROM AUTHOR]