Relation Between Job Strain, Alcohol, and Ambulatory Blood Pressure

“Job strain” (defined as high psychological demands and low decision latitude on the job) has been previously reported to be associated with increased risk of hypertension and increased left ventricular mass index (LVMI) in a case-control study of healthy employed men, aged 30–60 years, without evid...

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Bibliographic Details
Published in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 1992-05, Vol.19 (5), p.488-494
Main Authors: Schnall, Peter L, Schwartz, Joseph E, Landsbergis, Paul A, Warren, Katherine, Pickering, Thomas G
Format: Article
Language:English
Subjects:
Adult
Alcohol Drinking - physiopathology
Alcohol Drinking - psychology
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Blood Pressure
Blood Pressure Monitors
Cardiology. Vascular system
Cardiovascular System & Cardiology
Case-Control Studies
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Decision Making - physiology
Humans
Hypertension - etiology
Hypertension - physiopathology
Hypertension - psychology
Life Sciences & Biomedicine
Male
Medical sciences
Middle Aged
Occupational Diseases - etiology
Occupational Diseases - physiopathology
Occupational Diseases - psychology
Peripheral Vascular Disease
Science & Technology
Stress, Psychological - physiopathology
Stress, Psychological - psychology
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Summary:“Job strain” (defined as high psychological demands and low decision latitude on the job) has been previously reported to be associated with increased risk of hypertension and increased left ventricular mass index (LVMI) in a case-control study of healthy employed men, aged 30–60 years, without evidence of coronary heart disease. We hypothesized that job strain would be associated with increased ambulatory blood pressure (AmBP). A total of 264 men at eight work sites wore an AmBP monitor for 24 hours on a working day. In an analysis of covariance model, job strain was associated with an increase in systolic AmBP of 6.8 mm Hg (p=0.002) and diastolic AmBP of 2.8 mm Hg at work (p=0.03) after adjusting for age, race, body mass index, Type A behavior, alcohol behavior, smoking, work site, 24-hour urine sodium, education, and physical demand level of the job. Alcohol use also had a significant effect on AmBP. However, among subjects not in high-strain jobs, alcohol had no apparent effect on AmBP at work. Instead, alcohol use and job strain interacted such that workers in high-strain jobs who drank regularly had significantly higher systolic AmBP at work (p=0.007). Among the other risk factors, only age, body mass index, and smoking had significant effects on AmBP. Job strain also had significant effects on AmBP at home and during sleep us well as on LVMI. A large body of previous research that suggests job strain is a risk factor for the development of coronary heart disease may now be partially explained as the consequence of elevation of blood pressure and structural changes in the heart.
ISSN:0194-911X
1524-4563
DOI:10.1161/01.hyp.19.5.488