Relationship between hair cortisol status and blood pressure among chronic occupational stress-diagnosed healthcare professionals of Rivers State in Nigeria

Background: The relationship between chronic occupational stress (COS)-related hair cortisol concentration (HCC) and arterial blood pressure (ABP) is inconsistent within the relevant preexisting literature. Therefore, this study aimed to assess the impact of COS-related HCC on ABP among healthcare professionals (HPs) with a COS diagnosis. Methods: The cross-sectional study was conducted among 426 HPs in two healthcare settings in Rivers State, Southern Nigeria. Data were collected, including subjective measures of COS using the Effort-Reward Imbalance questionnaires, as well as objective measures of COS using HCC at >128 pg/mg hair. COS diagnoses were defined using combined subjective and objective measures. Statistical analyses were conducted at a 95% confidence interval and an alpha level of <0.05. Results: 273 (70%) had a COS diagnosis with a mean age of 32.44±5.24 years, and 9.2%, 61.2%, and 29.7% were normotensive, pre-hypertensive, and hypertensive, respectively (p<0.05). The pre-hypertensives and hypertensives were older and had higher mean HCC, body mass index (BMI), effort total score, effort-reward ratio, percentage of OC total score, but lower reward total score compared to the normotensives (p<0.05). HCC had a strong positive correlation with systolic blood pressure (crude beta: 0.724 versus adjusted beta: 0.706; p<0.001), but a moderate positive correlation with diastolic blood pressure (crude beta: 0.477 versus adjusted beta: 0.450; p<0.001). HCC, at >128 pg/mg hair, was associated with pre-hypertension (crude OR: 1.809 versus adjusted OR: 1.611; p<0.001) but more robust with hypertension (crude OR: 3.451 versus adjusted OR: 3.370; p<0.001). Conclusions: Current findings indicate a relationship between COS-associated HCC and the ABP indices, which should be considered during clinical management for COS.