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职业环境应激源对血压变化和高血压发病的影响:VISAT 研究的 5 年随访结果。

Impact of occupational environmental stressors on blood pressure changes and on incident cases of hypertension: a 5-year follow-up from the VISAT study.

机构信息

UMR1027, INSERM, Université Paul Sabatier Toulouse III, 31000, Toulouse, France.

Univ. Bordeaux, INSERM UMR 1219, Equipe EPICENE, F33000, Bordeaux, France.

出版信息

Environ Health. 2018 Nov 16;17(1):79. doi: 10.1186/s12940-018-0423-9.

Abstract

BACKGROUND

The role of occupational stressors (OS) on blood pressure (BP) is often suspected, but asserting its impact remains uncertain. Our goal was to evaluate their impact on BP increase and on incident cases of hypertension over a 5-year period.

METHODS

One thousand, one hundred and fifty-six men and women from the French prospective VISAT study were followed up over five-years (T1 to T2). Exposures to a large panel of OS (physical, organizational, psychosocial and employment categories) were collected. Linear and logistic regressions were used to assess associations between OS and T2-T1 SBP difference and incident cases of hypertension. They were performed to determine the role of OS first considered separately, then in combination, in crude and adjusted models for main cardiovascular risk factors (gender, age, education, BMI, lifestyle habits and medical history).

RESULTS

For initial SBP level < 130 mmHg, carrying loads, intense noise exposure, working more than 48 h/week, active and high strain tended to be associated with an SBP difference increase, while job recognition was associated with a decrease. After adjustment, only significant associations with job strain and job recognition persisted. For initial SBP level ≥ 130 mmHg, being exposed to an active job strain was positively associated with T2-T1 SBP difference only in unadjusted model. Considering all the OS, the recognition of completed tasks had a major protective role. No impact of OS on incident cases of hypertension was observed.

CONCLUSION

Associations between OS and SBP were observed mainly when initial SBP is within the normal range, and are mainly explained by cardiovascular factors, requiring physician's particular attention to people exposed to these OS. VISAT study is registered in "LE PORTAIL EPIDEMIOLOGIE - FRANCE- AVIESAN -ID 3666".

摘要

背景

职业应激源(OS)对血压(BP)的影响经常受到怀疑,但断言其影响仍然不确定。我们的目标是评估它们对 5 年内血压升高和高血压事件的影响。

方法

法国前瞻性 VISAT 研究中的 1156 名男性和女性在 5 年内(T1 至 T2)进行了随访。收集了大量职业应激源(物理、组织、心理社会和就业类别)的暴露情况。线性和逻辑回归用于评估 OS 与 T2-T1 SBP 差异和高血压事件之间的关系。它们用于确定 OS 的作用,首先单独考虑,然后在粗模型和调整后的主要心血管危险因素(性别、年龄、教育、BMI、生活方式习惯和病史)模型中考虑。

结果

对于初始 SBP 水平<130mmHg,携带负荷、高强度噪声暴露、每周工作超过 48 小时、积极和高压力倾向于与 SBP 差异增加相关,而工作识别与 SBP 差异减少相关。调整后,只有工作压力和工作识别与 SBP 差异显著相关。对于初始 SBP 水平≥130mmHg,仅在未调整模型中,暴露于积极的工作压力与 T2-T1 SBP 差异呈正相关。考虑到所有的 OS,完成任务的认可具有主要的保护作用。OS 对高血压事件没有影响。

结论

OS 与 SBP 之间的关联主要发生在初始 SBP 在正常范围内,主要由心血管因素解释,需要医生特别注意暴露于这些 OS 的人群。VISAT 研究在“LE PORTAIL EPIDEMIOLOGIE - FRANCE- AVIESAN -ID 3666”中注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fb1/6240201/07362579b5a1/12940_2018_423_Fig1_HTML.jpg

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