[Long-term analysis of hypertension in men by job type]

Health education intervention for hypertension require the assessment of hypertension. Risk factors for developing hypertension in Japanese workers were evaluated by the type of occupation: manager, office worker, salesperson, blue-collar worker, and engineer. A cohort of 2,257 male subjects, aged 21 through 63 years, who were normotensive, diastolic blood pressure less than 90 mm Hg and systolic blood pressure less than 140 mm Hg in the initial year, were followed for 15 years to observe the occurrence of hypertension. Hypertension was defined as a systolic blood pressure (SBP) of 160 mm Hg or higher and/or a diastolic blood pressure (DBP) of 95 mm Hg or higher, or the initiation of antihypertensive therapy. Eight risk factors related to hypertension (age, body mass index, cigarette smoking, job characteristic, alcohol consumption, stress, SBP, and DBP) were selected for analysis using Cox proportional hazards models. Stepwise model was utilized to incorporate risk factors for each type of occupation (p < 0.05). The following results were obtained: 1. The incidence of hypertension over 15-year analysis was 29.3% for the total male subjects. 2. Each type of occupation had a different pattern of risk factors for hypertension. 3. Blood pressure at baseline showed a significant association in all types of occupation, indicating a stronger relationship with hypertension than other factors. 4. Stress and age were significantly associated in managers, salespersons, and blue-collar workers. 5. Body mass index and alcohol consumption were significantly associated in salespersons. 6. Cigarette smoking was significant in managers and blue-collar workers, with the hazard ratio in managers being greater than 1 (1.66, 95%CI 1.06-2.60) but less than 1 in blue-collar workers (0.31, 95%CI 0.15-0.67). 7. In all types of occupation, job characteristic failed to reach statistical significance. Work-site primary prevention of hypertension should be performed specifically considering type of occupation. Individual risk assessment and lifestyle modification are potentially important tools for health education in the work-site and by applying this model to primary preventive care, appropriate preventive activities specific to an individual may be developed and provided.