title: Women, employment status, and hypertension: cross-sectional and prospective findings from the Atherosclerosis Risk in Communities (ARIC) Study.
abstract: OBJECTIVE
  This study examined the cross-sectional and prospective associations between employment status and hypertension among middle-aged, African-American (AA) and European-American (EA) women participating in the Atherosclerosis Risk in Communities Study.
  
  
  METHODS
  Employed women and homemakers from the baseline examination (1987-89) were included in the cross-sectional study (n = 7351). Associations between employment and the incidence of hypertension ascertained at visit 2 (1990-92) were determined among those who at baseline, had low-normal blood pressure (not hypertensive and systolic blood pressure (SBP) < or = 120 mm Hg systolic and diastolic blood pressure (DBP) < or =80 mm Hg (n = 3194). Logistic regression analysis was used to examine the association between employment status and hypertension by ethnicity, taking into account covariates.
  
  
  RESULTS
  At baseline, employed women were less likely to be hypertensive (SBP > or =140 mm Hg or DBP > or =90 mm Hg or current use of antihypertensive drugs) than were homemakers (prevalence odds ratio) (POR) = 0.70; 95% confidence interval (CI) = 0.62-0.79), controlling for age, body mass index, and education. Among the subgroup who had low-normal blood pressure at baseline, employed women were less likely to develop hypertension during the three-year time period than were homemakers (odds ratio (OR) = 0.68; 95% CI = 0.44-1.05). The inverse association was stronger among AA (RR = 0.37; 95% CI = 0.16-0.88) than EA (OR = 0.83; 95% CI = 0.50-1.38) women.
  
  
  CONCLUSIONS
  These findings suggest that the inverse association between hypertension and employment status is not due to a healthy worker effect, and that employment may confer protection against incident hypertension in women.
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, School of Public Health, 27514, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Rose
authors.forename: B
authors.initials: B
authors.lastname: Newman
authors.forename: H A
authors.initials: HA
authors.lastname: Tyroler
authors.forename: M
authors.initials: M
authors.lastname: Szklo
authors.forename: D
authors.initials: D
authors.lastname: Arnett
authors.forename: N
authors.initials: N
authors.lastname: Srivastava
mesh_terms: D001741:Black or African American; D001161:Arteriosclerosis / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011446:Prospective Studies; D044465:White People