title: Working and hypertension: gaps in employment not associated with increased risk in 13 European countries, a retrospective cohort study.
abstract: BACKGROUND
  There is growing evidence to suggest unemployment has a role in the development and incidence of cardiovascular disease. This study explores the contribution of breaks in employment to the development of hypertension, a key risk factor for coronary heart disease.
  
  
  METHODS
  We use data from the Survey of Health, Ageing, and Retirement in Europe to estimate the association between gaps in employment of 6 months or more ('Not Working', NW) and the incidence of hypertension in 9,985 individuals aged 50 or over across 13 European countries. Life history information including transitions in and out of employment was used to create a panel dataset where each visit represented one year of life between age 30 and incident hypertension or censoring (whichever came first). Pooled logistic models estimated the odds of hypertension according to the experience of not working, controlling for age at interview, age at each visit, gender, childhood socio-economic position, and country.
  
  
  RESULTS
  We consistently found no association between NW and hypertension, irrespective of the metrics used in defining the exposure or model specification.
  
  
  CONCLUSIONS
  There is the possibility of bias contributing to the null findings. However, given the relatively consistent evidence for an association between unemployment and cardiovascular outcomes in the literature, our results suggest there may be mechanisms - outside of hypertension - that have a comparatively greater contribution to this association.
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Suite 425, Toronto, ON M5T 3M6, Canada. jrs@otagoalumni.ac.nz.
authors.forename: Juliet
authors.initials: J
authors.lastname: Rumball-Smith
authors.forename: Arijit
authors.initials: A
authors.lastname: Nandi
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004651:Employment / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009786:Occupational Health Services; D012179:Retirement / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors