The relation of work-related factors with ambulatory blood pressure and nocturnal blood pressure dipping among aging workers

Saana Karelius,Jussi Vahtera,Annika S Lindroos,Pekka Jousilahti,Jaana Pentti,Olli J Heinonen,Sari Stenholm,Teemu J Niiranen

doi:10.1007/s00420-019-01510-8

Abstract

ObjectivesIndividuals with reduced nocturnal blood pressure (BP) dipping are at increased risk of cardiovascular disease compared to persons with normal BP dipping. Although the relation of work-related factors and BP has been studied extensively, very little is known of the association between work-related factors and 24-h BP patterns in aging workers. We examined the cross-sectional relation of work-related risk factors, including occupational status, work-time mode, job demands and job control, with ambulatory BP in aging workers, focusing on nocturnal BP dipping.Methods208 workers (mean age 62 ± 3 years; 75% women) from two Finnish population-based cohort studies underwent 24-h ambulatory BP monitoring. Work-related factors were inquired using a questionnaire. Nocturnal BP dipping was calculated as [1 − (asleep BP/awake BP)] × 100.ResultsShift workers demonstrated a higher nocturnal diastolic BP dipping than regular day workers (19% vs. 17%, p = 0.03) and had a significantly higher systolic awake BP than regular day workers (136.5 mmHg vs. 132.5 mmHg, p = 0.03). Participants with high job demands demonstrated a smaller nocturnal systolic BP dipping than participants with low job demands (14% vs. 16%, p = 0.04). We did not observe significant differences in nocturnal systolic or diastolic BP dipping between groups categorized by occupational status or job control.ConclusionsAlthough shift workers have a higher daytime BP than regular daytime workers, they exhibit greater nighttime BP dipping. Participants with high job demand had smaller nighttime BP dipping than participants with low job demand. Job control or occupation did not affect the 24-h ambulatory BP profile of aging workers.

Highlights

High blood pressure (BP) is one of the leading risk factors for premature death worldwide (GBD 2015 Risk Factors Collaborators 2016)
The mean awake BP was 128.7/77.8 mmHg, while the mean asleep BP was 110.8/63.9 mmHg. 50% of the participants had awake hypertension and 44% asleep hypertension. 21% were categorized as systolic non-dippers and 11% as diastolic non-dippers
We examined the association of occupational status, work-time mode, job demands and job control with ambulatory BP among aging workers

Summary

Introduction

High blood pressure (BP) is one of the leading risk factors for premature death worldwide (GBD 2015 Risk Factors Collaborators 2016). Job strain is known to associate with elevated office BP, but this association may be even stronger when BP is measured using 24-h ambulatory monitoring (Gilbert-Ouimet et al 2014). Compared to office BP, ambulatory BP offers possibility to measure nocturnal BP, a strong predictor of cardiovascular morbidity and mortality (Hermida et al 2011; Kikuya et al 2005). The nocturnal decline in BP (i.e., nocturnal BP dipping) has been shown to have incremental prognostic value on cardiovascular events independent of 24-h systolic BP, among hypertensive patients (Salles et al 2016). Individuals with reduced nocturnal BP dipping (nondippers) have been noted to have an increased risk for cardiovascular diseases compared to persons with normal nocturnal BP dipping (dippers) (Salles et al 2016)

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