Job constraints and arterial hypertension: different effects in men and women: the IHPAF II case control study

• Published in: Occupational and environmental medicine (London, England) Vol. 62; no. 10; pp. 711 - 717
• Main Authors: Radi, S, Lang, T, Lauwers-Cancès, V, Diène, E, Chatellier, G, Larabi, L, De Gaudemaris, R
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01-10-2005; BMJ Publishing Group; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adult; Alcohol Drinking; Biological and medical sciences; Blood pressure; BMI; Body mass index; Cardiovascular disease; case control; Case-Control Studies; Cohort analysis; Confounding Factors (Epidemiology); Employment; Female; Fundamental and applied biological sciences. Psychology; gender; Humans; Hypertension; Hypertension - physiopathology; IHPAF; Incidence of Hypertension in a French Working Population; Job Satisfaction; job strain; Life events; Male; Men; Obesity - physiopathology; Occupational Diseases - physiopathology; Occupational health; Occupational Medicine; Occupational psychology; Occupational stress; Occupations; Odds Ratio; Original; Predisposing factors; Psychological stress; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Questionnaires; Risk Factors; Scandals; sex; Sex Distribution; Social Support; Stress; Stress, Psychological; Women; Work condition. Job performance. Stress; Work Schedule Tolerance; Workers; Working conditions; Working women; France; Europe; Human; Hypertension; Sex; Cardiovascular disease; Male; Case control study; Epidemiology; Stress; Occupational environment; Blood vessel; Female; Circulatory system; Working condition; Woman
• ISSN: 1351-0711; 1470-7926
• DOI: 10.1136/oem.2004.012955

Aims: To examine, in a working population of men and women, the relation between organisational job constraints (job strain, passive and active jobs) and incident hypertension and the buffering effect of social support at work on this relation. Methods: A nested case control study was designed within the IHPAF (Incidence of Hypertension in a French Working Population) cohort study. The 20 worksite physicians participating in the study enrolled 203 cases and matched each case for age (SD 10 years) and sex with two normotensive subjects attending the follow up screening immediately after him or her. As a result, 426 men and 183 women were included in the study. Results: Mean age was 41.8 (SD 7.8) years in men and 43.5 (SD 7.5) years in women. Relations between job constraints and hypertension were stronger in women than in men. Odds ratios (OR) were 3.20 (95% CI 0.92 to 11.12) in women and 2.60 (95% CI 1.15 to 5.85) in men for job strain, 4.73 (95% CI 1.36 to 16.42) in women and 2.30 (95% CI 1.01 to 5.26) in men for passive jobs, and 4.51 (95% CI 1.24 to 16.43) in women and 2.39 (95% CI 1.10 to 5.18) in men for active jobs. Low social support at work was not related to hypertension and did not decrease the association with organisational risk factors. In both hypertensive men and women, obesity was related to hypertension (OR = 13.20 (95% CI 3.34 to 52.14) in women and 6.54 (95% CI 2.99 to 14.29) in men) and the prevalence of recent stressful life events was significantly lower in hypertensive women (OR = 0.32 (95% CI 0.12 to 0.89)) and men (OR = 0.37 (95% CI 0.20 to 0.67) compared with normotensives. Alcohol consumption was a significant risk factor for hypertension in women (OR = 3.47 (95% CI 1.18 to 10.25)). Conclusion: A stronger relation between job constraints and hypertension was observed in women compared with men. These findings emphasise the need of addressing more sex-specific concepts of work related stress on the one hand, and of understanding the direct and indirect mechanisms linking psychosocial factors and hypertension in both sexes on the other hand.