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Working conditions and masked hypertension.
Paul A Landsbergis1, Arlene Travis, Peter L Schnall
1Department 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. paul.landsbergis@downstate.edu
Summary
Shift work and job stress are linked to masked hypertension, a condition with normal clinic blood pressure but elevated readings during daily activities. This highlights work-related factors as significant contributors to cardiovascular risk.
Area of Science:
- Occupational Health
- Cardiovascular Medicine
- Epidemiology
Background:
- Masked hypertension, characterized by normal clinic blood pressure but elevated readings during daily activities, is a significant cardiovascular risk factor.
- Previous research suggests a link between work stressors and ambulatory blood pressure, warranting investigation into work stressors and masked hypertension.
Purpose of the Study:
- To investigate the association between working conditions and the prevalence of masked hypertension among healthcare employees.
Main Methods:
- A cross-sectional study was conducted with 45 male and 119 female hospital and home care employee volunteers in New York City.
- Ambulatory blood pressure monitoring was used during working hours to define masked hypertension (work systolic BP ≥135 mmHg or diastolic BP ≥85 mmHg, with casual BP <140/90 mmHg and no antihypertensive medication).
- Multiple logistic regression analysis was employed to assess the relationship between work stressors and masked hypertension, controlling for potential confounders.
Main Results:
- Masked hypertension was identified in 24.0% of males and 17.6% of females with normal casual blood pressure.
- Shift work (evening, night, or rotating) was significantly associated with masked hypertension (OR 8.25, 95% CI 2.11-40.31).
- A combination of job strain and effort-reward imbalance also showed an association with masked hypertension (OR 2.97, 95% CI 1.02-8.60), whereas total weekly work hours were not associated.
Conclusions:
- Masked hypertension presents a substantial individual and public health challenge.
- Work-related risk factors, particularly shift work and specific job stress profiles, play a significant role in the development of masked hypertension.
- Further research is essential to elucidate these work-related factors and to establish effective strategies for diagnosis, treatment, and prevention.
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