Repeated exposure to effort-reward imbalance, increased blood pressure, and hypertension incidence among white-collar workers: effort-reward imbalance and blood pressure.
OBJECTIVE
To determine whether men and women with repeated ERI exposure have increased BP means or higher hypertension incidence over a 3-year follow-up. To examine the potential modifying effect of age and overcommitment.


METHODS
The study cohort was composed of 1,595 white-collar workers (629 men and 966 women) assessed at baseline and 3-year follow-up. Ambulatory BP measures were taken every 15 min during a working day. ERI at work was self-reported using validated scales. BP means at follow-up and cumulative incidence of hypertension were respectively modeled with analyses of covariance (ANCOVA) and log-binomial regression.


RESULTS
Among men, no association was observed between repeated ERI exposure and BP. Among women, age had a modifying effect. Women <45 years old exposed to ERI at both times had significantly higher BP means at follow-up (122.2/78.9 mmHg) than those unexposed (120.4/77.4 mmHg). In women ≥45 years old, the cumulative incidence of hypertension was 2.78 (95% CI: 1.26-6.10) times higher among those exposed to ERI at both times. Men and women in the higher tertile of overcommitment had higher BP means (men: 128.9/82.2 mmHg, women: 121.9/78.0 mmHg) than those in the lower tertile (men: 127.2/81.3 mmHg, women: 120.6/77.0 mmHg).


CONCLUSIONS
This prospective study showed that, among women, repeated ERI exposure led to a significant age-specific increase in BP means and a major age-specific increase in hypertension incidence. These results suggest that primary intervention aimed at reducing ERI may contribute to lower BP and prevent hypertension in women.
Santé des Populations: URESP, Centre de Recherche FRSQ du Centre Hospitalier affilié Universitaire de Quebec City, Québec, Canada. mahee.g.ouimet@gmail.com
M
M
Gilbert-Ouimet
C
C
Brisson
M
M
Vézina
A
A
Milot
C
C
Blanchette
D000328:Adult; D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology*; D030141:Feedback, Psychological / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015994:Incidence; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011446:Prospective Studies; D012201:Reward; D012737:Sex Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D016526:Workload; D017132:Workplace / Q000523:psychology*