Key result
Combined exposure to active jobs and effort-reward imbalance was associated with increased hypertension risk over 18 years (HR 1.34; 95% CI 1.14-1.56), as was high job strain over 24 years (HR 1.26).
Why the study?
Psychosocial stressors at work from the job strain and effort-reward imbalance (ERI) models are associated with increased blood pressure levels, but the adverse effect of combined exposure to both work stressors on hypertension incidence remained unknown.
Does exposure to psychosocial stressors at work (job strain and effort-reward imbalance, separately and in combination) increase the risk of incident hypertension in normotensive white-collar workers?
Cohort (n=9,188)
Does exposure to psychosocial stressors at work (job strain and effort-reward imbalance, separately and in combination) increase the risk of incident hypertension in normotensive white-collar workers?
Psychosocial work stressors from both the job strain and effort-reward imbalance models are independently and additively associated with an increased long-term risk of developing hypertension in white-collar workers.
Answers are grounded in this paper and cite their sources.
Work stressors may inform occupational hypertension prevention; extends prior BP associations but leaves causal effects and interventions open.
OBJECTIVES: 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: N = 6732 over 24 years (T1 to T3) and N = 4516 over 18 years (T2 to T3). 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.
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Konan et al. (2026) conducted a cohort in Hypertension incidence (n=9,188). Psychosocial stressors at work (job strain and effort-reward imbalance models) vs. Unexposed to psychosocial work stressors was evaluated on Incident hypertension identified using medico-administrative databases and automated office blood pressure measurements (HR 1.34, 95% CI 1.14-1.56). Combined exposure to active jobs and effort-reward imbalance was associated with increased hypertension risk over 18 years (HR 1.34; 95% CI 1.14-1.56), as was high job strain over 24 years (HR 1.26).
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