Xu Weixian, Yu Haiyi, Hang Juan, Gao Wei, Zhao Yiming, Guo Lijun
Department of Cardiology, Peking University Third Hospital and Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China.
Am J Ind Med. 2013 Dec;56(12):1433-41. doi: 10.1002/ajim.22254. Epub 2013 Sep 13.
No previous studies investigated the interaction of effort-reward imbalance (ERI) and overcommitment on blood pressure. Our aim was to investigate associations of ERI and overcommitment (and their interaction) with blood pressure and hypertension within a Chinese population.
Seven hundred thirty-four participants from the Stress and Health in Shenzhen Workers study completed a demographics, job stressor and risk factor questionnaire, and their blood pressure was measured by mercury sphygmomanometers. Risk factors for blood pressure were analyzed by multiple linear regression and risk factors for hypertension by Poisson regression.
Overcommitment was associated with diastolic blood pressure after adjustment for confounders and ERI among men (β = 0.17, P < 0.05); ERI was also associated with diastolic blood pressure and systolic blood pressure after adjustment for confounders and overcommitment. High overcommitment (PR 1.91, 95% CI 1.35-2.69), and ERI (PR = 2.47, 95% CI 1.62-3.75) were each associated with risk of hypertension after adjusting for confounders. After adjusting for ERI, the association with overcommitment was no longer significant (PR = 1.24, 95% CI 0.85-1.82) However, after controlling for overcommitment, ERI remained significantly associated with hypertension risk (PR = 2.38, 95% CI 1.53-3.71). When high overcommitment and high ERI was combined, hypertension risk was highest (adjusted PR = 2.99, 95% CI 1.82-4.91, adjusted synergy index 5.85). The interaction was significant when it was tested by an interaction term in the regression (P < 0.001).
The interaction effect of overcommitment and ERI on hypertension was independent and synergistic.
既往尚无研究探讨努力-回报失衡（ERI）与过度投入对血压的相互作用。我们的目的是在中国人群中研究ERI和过度投入（及其相互作用）与血压和高血压之间的关联。
来自深圳工人压力与健康研究的734名参与者完成了一份人口统计学、工作压力源和风险因素问卷，并用汞柱式血压计测量了他们的血压。通过多元线性回归分析血压的风险因素，通过泊松回归分析高血压的风险因素。
在对男性的混杂因素和ERI进行调整后，过度投入与舒张压相关（β = 0.17，P < 0.05）；在对混杂因素和过度投入进行调整后，ERI也与舒张压和收缩压相关。在对混杂因素进行调整后，高过度投入（PR 1.91，95%CI 1.35 - 2.69）和ERI（PR = 2.47，95%CI 1.62 - 3.75）均与高血压风险相关。在对ERI进行调整后，与过度投入的关联不再显著（PR = 1.24，95%CI 0.85 - 1.82）。然而，在控制过度投入后，ERI仍与高血压风险显著相关（PR = 2.38，95%CI 1.53 - 3.71）。当高过度投入和高ERI同时存在时，高血压风险最高（调整后的PR = 2.99，95%CI 1.82 - 4.91，调整后的协同指数5.85）。通过回归中的交互项进行检验时，交互作用显著（P < 0.001）。
过度投入和ERI对高血压的交互作用是独立且协同的。
