Boucher P, Gilbert-Ouimet M, Trudel X, Duchaine C S, Milot A, Brisson C
Population Health and Optimal Health Practices Unit, CHU de Québec-Université Laval Research Center, Quebec, Quebec, Canada.
Department of Social and Preventive Medicine, Faculty of Medicine, Laval University, Quebec, Quebec, Canada.
J Hum Hypertens. 2017 Oct;31(10):620-626. doi: 10.1038/jhh.2017.42. Epub 2017 Jun 22.
Hypertension is an important risk factor of cardiovascular diseases, the leading cause of death worldwide. Adverse effects of psychosocial factors at work might increase the risk of masked hypertension, but evidences are still scarce. The objective of this study is then to determine whether adverse psychosocial work factors from the effort-reward imbalance (ERI) model are associated with the prevalence of masked hypertension in a population of white-collar workers. White-collar workers were recruited from three public organizations. Blood pressure was measured at the workplace for manually operated measurements (mean of the first three readings taken by a trained assistant) followed by ambulatory measurements (mean of all subsequent readings taken during the working day). Masked hypertension was defined as manually operated BP<140/90 mm Hg and ambulatory BP ⩾135/85 mm Hg. ERI exposure at work was measured using Siegrist's validated questionnaire. Blood pressure readings were obtained from 2369 workers (participation proportion: 85%). ERI exposure (OR: 1.53 (95% CI: 1.16-2.02) and high efforts at work (OR: 1.61 (95% CI: 1.13-1.29) were associated with masked hypertension, after adjusting for sociodemographic and cardiovascular risk factors. Workers exposed to an imbalance between efforts spent at work and reward had a higher prevalence of masked hypertension. High efforts at work might be of particular importance in explaining this association. Future studies should be designed to investigate how clinicians can include questions on psychosocial work factors to screen for masked hypertension and how workplace interventions can decrease adverse psychosocial exposures to lower BP.
高血压是心血管疾病的重要危险因素，而心血管疾病是全球主要的死亡原因。工作中的社会心理因素的不利影响可能会增加隐匿性高血压的风险，但相关证据仍然匮乏。因此，本研究的目的是确定努力-回报失衡（ERI）模型中的不良社会心理工作因素是否与白领人群中隐匿性高血压的患病率相关。从三个公共组织招募了白领员工。在工作场所测量血压，包括手动测量（由训练有素的助手进行的前三次读数的平均值），随后进行动态测量（工作日期间所有后续读数的平均值）。隐匿性高血压定义为手动测量血压<140/90 mmHg且动态血压⩾135/85 mmHg。使用西格里斯特经过验证的问卷测量工作中的ERI暴露情况。从2369名员工中获取了血压读数（参与比例：85%）。在调整了社会人口统计学和心血管危险因素后，ERI暴露（比值比：1.53（95%置信区间：1.16-2.02））和工作中的高努力程度（比值比：1.61（95%置信区间：1.13-1.29））与隐匿性高血压相关。工作中付出的努力与回报失衡的员工隐匿性高血压患病率更高。工作中的高努力程度在解释这种关联方面可能尤为重要。未来的研究应设计调查临床医生如何纳入关于社会心理工作因素的问题以筛查隐匿性高血压，以及工作场所干预如何减少不良社会心理暴露以降低血压。
