title: The Role of Occupational Status in the Association Between Job Strain and Ambulatory Blood Pressure During Working and Nonworking Days.
abstract: The objectives of this study were to determine whether job strain is more strongly associated with higher ambulatory blood pressure (ABP) among blue-collar workers compared with white-collar workers, to examine whether this pattern generalizes across working and nonworking days and across sex, and to examine whether this pattern is accounted for by psychosocial factors or health behaviors during daily life.
  
  
  
  A total of 480 healthy workers (mean age = 43 years, 53% female) in the Adult Health and Behavior Project-Phase 2 completed ABP monitoring during 3 working days and 1 nonworking day. Job strain was operationalized as high psychological demand (> sample median) combined with low decision latitude (<sample median; Karasek model; Job Content Questionnaire).
  
  
  
  Covariate-adjusted multilevel random coefficient regressions demonstrated that associations between job strain and systolic and diastolic ABP were stronger among blue-collar workers compared with white-collar workers (b = 6.53 [F(1,464) = 3.89, p = .049] and b = 5.25 [F(1,464) = 6.09, p = .014], respectively). This pattern did not vary by sex, but diastolic ABP findings were stronger when participants were at work. The stronger association between job strain and ABP among blue-collar workers was not accounted for by education, momentary physical activity, or substance use, but was partially accounted for by covariation between higher hostility and blue-collar status.
  
  
  
  Job strain is associated with ABP among blue-collar workers. These results extend previous findings to a mixed-sex sample and nonworking days and provide, for the first time, comprehensive exploration of several behavioral and psychosocial explanations for this finding.
authors.affiliation: From the Social Sciences Division (Joseph), Pepperdine University, Malibu, California; Heart and Vascular Institute, Department of Medicine (Muldoon), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Departments of Psychology (Manuck); Psychiatry, Psychology, and Epidemiology (Matthews); and Psychology and Psychiatry (Kamarck), University of Pittsburgh, Pittsburgh, Pennsylvania; and National Institute for Occupational Safety and Health (MacDonald, Grosch), Washington DC.
authors.forename: Nataria T
authors.initials: NT
authors.lastname: Joseph
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Muldoon
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Manuck
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
authors.forename: Leslie A
authors.initials: LA
authors.lastname: MacDonald
authors.forename: James
authors.initials: J
authors.lastname: Grosch
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Kamarck
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D009790:Occupations / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000453:epidemiology*; D013997:Time Factors