What does this research mean for the field?

Organizational job constraints, including job strain, passive, and active jobs, are more strongly associated with incident hypertension in women than in men, and this relationship is not buffered by social support at work. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

September 16, 2005Open Access

Job constraints and arterial hypertension: different effects in men and women: the IHPAF II case control study

Structured PICO

Do organisational job constraints increase the risk of incident hypertension in working men and women?

Population

609 working adults (203 incident hypertension cases matched with 406 normotensive controls), including 426 men (mean age 41.8) and 183 women (mean age 43.5) from a French working population.

Intervention

Organisational job constraints (job strain, passive and active jobs)

Comparator

Absence of or lower levels of job constraints

Outcome

Incident hypertensionsurrogate

Job constraints, including job strain and passive/active jobs, are associated with an increased risk of incident hypertension, with a more pronounced effect in women.

Abstract

AIMS: To examine, in a working population of men and women, the relation between organisational job constraints (job strain, passive and active jobs) and incident hypertension and the buffering effect of social support at work on this relation. METHODS: A nested case control study was designed within the IHPAF (Incidence of Hypertension in a French Working Population) cohort study. The 20 worksite physicians participating in the study enrolled 203 cases and matched each case for age (SD 10 years) and sex with two normotensive subjects attending the follow up screening immediately after him or her. As a result, 426 men and 183 women were included in the study. RESULTS: Mean age was 41.8 (SD 7.8) years in men and 43.5 (SD 7.5) years in women. Relations between job constraints and hypertension were stronger in women than in men. Odds ratios (OR) were 3.20 (95% CI 0.92 to 11.12) in women and 2.60 (95% CI 1.15 to 5.85) in men for job strain, 4.73 (95% CI 1.36 to 16.42) in women and 2.30 (95% CI 1.01 to 5.26) in men for passive jobs, and 4.51 (95% CI 1.24 to 16.43) in women and 2.39 (95% CI 1.10 to 5.18) in men for active jobs. Low social support at work was not related to hypertension and did not decrease the association with organisational risk factors. In both hypertensive men and women, obesity was related to hypertension (OR = 13.20 (95% CI 3.34 to 52.14) in women and 6.54 (95% CI 2.99 to 14.29) in men) and the prevalence of recent stressful life events was significantly lower in hypertensive women (OR = 0.32 (95% CI 0.12 to 0.89)) and men (OR = 0.37 (95% CI 0.20 to 0.67) compared with normotensives. Alcohol consumption was a significant risk factor for hypertension in women (OR = 3.47 (95% CI 1.18 to 10.25)). CONCLUSION: A stronger relation between job constraints and hypertension was observed in women compared with men. These findings emphasise the need of addressing more sex-specific concepts of work related stress on the one hand, and of understanding the direct and indirect mechanisms linking psychosocial factors and hypertension in both sexes on the other hand.

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