[Arterial hypertension and socioeconomic status in a representative population of French railway drivers].

UNLABELLED

High blood pressure (HDP) is known as a cardiovascular risk factor depending both on environmental and socio-economic factors.

METHODS

From October 1993 to october 1994 a cross sectional study was carried out among 1,855 French railway drivers (FRD) representative of the 17,432 males FRD, aged 25 to 54 years. Age, weight, height, hip and waist, smoking, living area, type of train they drove (goods, suburban, TGV, inter-city trains), their grade (3 grades) were recorded. HBP corresponds to systolic blood pressure (BP) 160 mmHg or diastolic BP > or = 95 mmHg or to normal BP under antihypertensive medication. The analysis was carried out according to 2 age classes: 20-36/37-54 years.

RESULTS

In our sample 8.5% of FRD suffered from HBP, 3.5% in the younger class, and 13.5% in the other one. Using univariate analysis, among the oldest, subjects with lower grades suffered more often from HBP (19%). Paris area was more often related to HBP for the 20-36 years (6.7%). This was the case for the oldest living in Paris area (19.7%), and the North East (15.2%). Subjects with central obesity (19.9 vs 6%), and hyperlipidemic FRD (20.9 vs 10.9%) were more often related to HBP in the 35-54 years group Whatever the type of train they drove no difference was found. In multivariate analysis, (stepwise logistic regression BMDP LR) independent HBP factors are: age OR 3.4 IC 1.9-5.9 (20-36 vs 37-54), central obesity OR 1.7 IC 1.1-2.6, tobacco consumption OR 2.1 IC 1.2-3.5 (smokers vs non smokers), ex-smokers: OR 2.3 IC 1.3-3.9 (Ex-smokers vs non smokers), living area (all regions vs South East in the Mediterranean border). Nevertheless, grades and type of train they drove were not independent factors.

CONCLUSION

These results show the determining part played by environmental factors: age, central obesity, living area and tobacco consumption in the determinism of HBP in professional background: these factors can account for the difference observed in professional factor (grade).