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不同年龄组职业相对有氧工作量与静息血压之间的关联:DPhacto研究中的横断面分析

Associations between occupational relative aerobic workload and resting blood pressure among different age groups: a cross-sectional analysis in the DPhacto study.

作者信息

Korshøj Mette, Clays Els, Krause Niklas, Gupta Nidhi, Jørgensen Marie Birk, Holtermann Andreas

机构信息

Unit of Muscoloskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark

Department of Public Health, Universiteit Gent, Gent, Belgium.

出版信息

BMJ Open. 2019 Sep 24;9(9):e029713. doi: 10.1136/bmjopen-2019-029713.

Abstract

OBJECTIVE

High levels of occupational physical activity (OPA) increase heart rate, blood pressure (BP) and the risk of hypertension. Older workers may be more vulnerable to high levels of OPA due to age-related degeneration of the cardiovascular system and cardiorespiratory fitness. This study investigates the association of relative aerobic workload (RAW) with resting BP and examines if this relation is moderated by age.

DESIGN

Cross-sectional epidemiological study.

SETTING

Data were collected among employees of 15 Danish companies in the cleaning, manufacturing and transport sectors.

PARTICIPANTS

2107 employees were invited for participation, of these 1087 accepted and 562 (42% female and 4% non-Westerns) were included in the analysis based on the criteria of being non-pregnant, no allergy to bandages, sufficient amount of heart rate data corresponding to ≥4 work hours per workday or 75% of average work hours, and no missing outcome and confounder values.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measure was BP.

RESULTS

Heart rate reserve was estimated from ambulatory 24-hour heart rate measures covering 2.5 workdays per participant (SD 1.0 day). Age significantly moderated the association between RAW and BP. Mean intensity and duration of high RAW (≥30% heart rate reserve) showed positive associations with diastolic BP and negative associations with pulse pressure (PP) among participants ≥47 years old. Tendencies towards negative associations between RAW and BP were seen among participants <47 years old.

CONCLUSIONS

Mean intensity and duration of RAW increased diastolic BP among participants ≥47 years old. Negative associations with PP may be due to healthy worker selection bias. Prevention of hypertension should consider reductions in RAW for ageing workers.

摘要

目的

高水平的职业体力活动(OPA)会增加心率、血压(BP)以及患高血压的风险。由于心血管系统与心肺适能的年龄相关性退变,年长的劳动者可能更容易受到高水平OPA的影响。本研究调查相对有氧工作量(RAW)与静息血压之间的关联,并检验这种关系是否受年龄的调节。

设计

横断面流行病学研究。

背景

数据收集于丹麦15家清洁、制造和运输行业公司的员工中。

参与者

邀请了2107名员工参与,其中1087名接受邀请,基于非怀孕、对绷带无过敏反应、有对应每个工作日≥4工作小时或平均工作小时75%的足够心率数据、无缺失结局和混杂因素值的标准,562名(42%为女性,4%为非西方人)被纳入分析。

主要和次要结局指标

主要结局指标为血压。

结果

通过每位参与者2.5个工作日的动态24小时心率测量估计心率储备(标准差1.0天)。年龄显著调节了RAW与血压之间的关联。在47岁及以上的参与者中,高RAW(≥30%心率储备)的平均强度和持续时间与舒张压呈正相关,与脉压(PP)呈负相关。在47岁以下的参与者中,可见RAW与血压之间存在负相关趋势。

结论

在47岁及以上的参与者中,RAW的平均强度和持续时间增加了舒张压。与PP的负相关可能归因于健康工人选择偏倚。预防高血压应考虑降低年长劳动者的RAW。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd5/6773343/2e82945f97ef/bmjopen-2019-029713f01.jpg

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