Psychosocial stressors at work and hypertension incidence: a prospective cohort study of multiple exposures
Flore A. Konan, Alain Milot, Chantal Brisson, Denis Talbot, Mahée Gilbert-Ouimet, Mathilde Lavigne-Robichaud, Xavier TrudelObjectives:
Psychosocial stressors at work from the job strain and effort-reward imbalance (ERI) models are frequent and modifiable exposures associated with increased blood pressure levels. The adverse effect of combined exposure to both work stressors on hypertension incidence remains unknown. This study aimed to examine this association in a long-term prospective cohort.
Methods:
The study included 9188 white-collar workers recruited at T1 (1991–1993), with follow-ups at T2 (1999–2001) and T3 (2015–2018). Exposures to psychosocial stressors at work from the job strain (T1 and T2) and ERI (T2) models were measured using validated instruments. Incident hypertension cases were identified using medico-administrative databases and automated office blood pressure measurements. Semi-parametric proportional hazards models were used to estimate hazard ratios (HR). Analyses included normotensive workers at baseline:
Results:
Over 24 years, workers exposed to passive jobs [low psychological demands and low decision latitude; HR = 1.19 (95% confidence interval (CI): 1.05–1.34)], active jobs [high psychological demands and high decision latitude; HR = 1.23 (95% CI: 1.08–1.40)], and high strain [high psychological demands and low decision latitude; HR = 1.26 (95% CI: 1.11–1.44)] had an increased risk of hypertension. Over 18 years, workers exposed to active jobs [HR = 1.20 (95% CI: 1.03–1.39)], ERI [HR = 1.19 (95% CI: 1.06–1.33)], and both [HR = 1.34 (95% CI: 1.14–1.56)] had an increased risk of hypertension.
Conclusions:
Psychosocial stressors at work from the job strain and ERI models were associated, separately and in combination, with an increased risk of hypertension.