National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480, Manguinhos, 21041-210 Rio de Janeiro, Rio de Janeiro, Brazil.
Scientific Computing Program, Oswaldo Cruz Foundation, Avenida Brasil, 4365, Manguinhos, 21040-360 Rio de Janeiro, Rio de Janeiro, Brazil.
Int J Environ Res Public Health. 2017 Apr 22;14(4):451. doi: 10.3390/ijerph14040451.
Methodological issues are pointed to as the main sources of inconsistencies in studies about the association between job strain and blood pressure (BP)/hypertension. Our aim was to analyze the relationship between job strain and the whole BP distribution, as well as potential differences by gender, age, and use of antihypertensives. Additionally, we addressed issues relating to the operationalization of the exposure and outcome variables that influence the study of their inter-relations. We evaluated the baseline date of 12,038 participants enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) (2008-2010), a multicenter cohort study of 35-74-year-old civil servants. Job strain was assessed by the Demand-Control-Support Questionnaire. The distribution of casual BP by categories of job strain was compared by a combination of exploratory techniques. Participants were classified into three subgroups (normotensives, medicated hypertensives, and unmedicated hypertensives), and analyses were stratified by gender and age. The relationship between job strain and casual BP varied along the whole outcome distribution. Hypertensive participants had greater differences in casual BP by job strain category, especially medicated hypertensives. Differences in casual BP were also greater for systolic than for diastolic BP and for older participants. No differences were encountered by gender. The exclusion of participants susceptible to misclassification for the exposure and outcome variables increased the differences observed between the categories of low and high job strain. In conclusion, the relationship between job strain and casual BP varied along the whole outcome distribution and by use of antihypertensive drugs, age, and BP parameter evaluated. Misclassification for exposure and outcome variables should be considered in analyses of this topic.
方法学问题被指出是研究工作压力与血压（BP）/高血压之间关联的不一致的主要原因。我们的目的是分析工作压力与整个 BP 分布之间的关系，以及性别、年龄和使用抗高血压药物的潜在差异。此外，我们还解决了与暴露和结局变量的操作化相关的问题，这些问题会影响对它们相互关系的研究。我们评估了巴西成人健康纵向研究（ELSA-Brasil）（2008-2010 年）的 12038 名参与者的基线数据，这是一项针对 35-74 岁公务员的多中心队列研究。工作压力通过需求-控制-支持问卷进行评估。通过探索性技术组合比较了不同工作压力类别下的偶然 BP 分布。参与者被分为三组（正常血压者、药物治疗的高血压者和未药物治疗的高血压者），并按性别和年龄进行分层分析。工作压力与偶然 BP 的关系沿整个结局分布而变化。高血压参与者在工作压力类别方面的偶然 BP 差异更大，尤其是药物治疗的高血压者。与舒张压相比，收缩压的偶然 BP 差异也更大，且在年龄较大的参与者中差异更大。性别方面没有差异。排除对暴露和结局变量易发生错误分类的参与者增加了高低工作压力类别之间观察到的差异。总之，工作压力与偶然 BP 的关系沿整个结局分布以及使用抗高血压药物、年龄和评估的 BP 参数而变化。在分析这个主题时，应该考虑暴露和结局变量的错误分类。
Zotero 插件
