title: Perceived stress, sex and occupational status interact to increase the risk of future high blood pressure: the IPC cohort study.
abstract: BACKGROUND
  Contrary to lay beliefs, current perceived stress is not consistently associated with the incidence of high blood pressure (BP) in prospective studies, possibly because of moderating factors. The present prospective study examined this association and explored the potential moderating effects of sex or occupational status.
  
  
  METHODS
  The 4-item Perceived Stress Scale was filled at baseline by 19 766 normotensive adults (13 652 men, mean age ± SD: 46.8 ± 9.3 years), without history of cardiovascular and renal disease, and not on either psychotropic or antihypertensive drugs.
  
  
  RESULTS
  After a mean follow-up of 5.8 ± 2.1 years, 3774 participants (19.1%) had high BP, defined as having a SBP at least 140 mmHg or a DBP at least 90 mmHg, or using antihypertensive drugs. There was a significant interaction between baseline-perceived stress and sex (P = 0.02) in relation to high BP at follow-up. After adjustment for potential confounders, baseline perceived stress was associated with high BP at follow-up in women [odds ratio 1.20, 95% confidence interval 1.03-1.38, P = 0.016). In addition, the interaction between perceived stress and occupational status was significant among women (P = 0.02). Baseline-perceived stress was positively associated with high BP at follow-up among women of medium or low occupational status, with odds ratio suggesting a linear increase of the risk (P = 0.005).
  
  
  CONCLUSIONS
  Perceived stress may be considered as a risk factor for hypertension in women of lower occupational status. Research addressing the relationships between stress and high BP should systematically look for possible interactions with sex and occupational status.
authors.affiliation: aUniv Paris Descartes, Sorbonne Paris Cité, Faculté de médecine bInserm U894, Centre Psychiatrie et Neurosciences, Paris cInserm, Centre for research in Epidemiology and Population Health, U1018, Epidemiology of Occupational and Social Determinants of Health Team, Villejuif dUniv Versailles St-Quentin, UMRS1018, Versailles eIPC Center, Paris fHopital Manhes, Fleury-Mérogis gInserm UMS-011, Population-Based Epidemiological Cohorts, Villejuif hAP-HP, Hôpital Ambroise Paré, Unité de Nutrition, Boulogne-Billancourt iAP-HP, Hôpital Broca, Service de Gériatrie jUniv Pierre et Marie Curie (UPMC) kAP-HP, Hôpital St Antoine lAP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service d'Oncologie Radiothérapique mAP-HP, Hôpitaux Universitaires Paris Ouest, Service de Cardiologie nAP-HP, Hôpitaux Universitaires Paris Ouest, Service universitaire de Psychiatrie de l'adulte et du sujet âgé, Paris, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Wiernik
authors.forename: Hermann
authors.initials: H
authors.lastname: Nabi
authors.forename: Bruno
authors.initials: B
authors.lastname: Pannier
authors.forename: Sébastien
authors.initials: S
authors.lastname: Czernichow
authors.forename: Olivier
authors.initials: O
authors.lastname: Hanon
authors.forename: Tabassome
authors.initials: T
authors.lastname: Simon
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Simon
authors.forename: Frédérique
authors.initials: F
authors.lastname: Thomas
authors.forename: Cyril
authors.initials: C
authors.lastname: Ducolombier
authors.forename: Nicolas
authors.initials: N
authors.lastname: Danchin
authors.forename: Frédéric
authors.initials: F
authors.lastname: Limosin
authors.forename: Silla M
authors.initials: SM
authors.lastname: Consoli
authors.forename: Cédric
authors.initials: C
authors.lastname: Lemogne
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D015331:Cohort Studies; D004651:Employment; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000503:physiopathology
chemical_list: D000959:Antihypertensive Agents