Psychosocial Stressors at Work and Ambulatory Blood Pressure
- 86 Downloads
Purpose of Review
Psychosocial stressors at work from the demand-latitude and effort-reward imbalance models are adverse exposures affecting about 20–25% of workers in industrialized countries. This review aims to summarize evidence on the effect of these stressors on blood pressure (BP).
Three systematic reviews have recently documented the effect of these psychosocial stressors at work on BP. Among exposed workers, statistically significant BP increases ranging from 1.5 to 11 mmHg have been observed in prospective studies using ambulatory BP (ABP). Recent studies using ABP have shown a deleterious effect of these psychosocial stressors at work on masked hypertension as well as on blood pressure control in pharmacologically treated patients.
Evidence on the effect of these psychosocial stressors on BP supports the relevance to tackle these upstream factors for primary prevention and to reduce the burden of poor BP control. There is a need for increased public health and clinical awareness of the occupational etiology of high BP, hypertension, and poor BP control.
KeywordsPsychosocial stressors at work Job strain Effort-reward imbalance Ambulatory blood pressure Masked hypertension Hypertension control
Compliance with Ethical Standards
Conflict of Interest
Xavier Trudel, Chantal Brisson, Mahée Gilbert-Ouimet, and Alain Milot declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.Parent-Thirion A, Fernandez Macías E, Hurley J, Vermeylen GG. Fourth European Working Conditions Survey. Luxembourg; 2007.Google Scholar
- 2.Compton S. What’s stressing the stressed? Main sources of stress among workers. Statistics Canada Catalogue. 2011;11-008:44–51.Google Scholar
- 3.Sauter S, Murphy L, Colligan M, Swanson N, Hurrell JJ, Scharf FJ, et al. Stress ... at work. Cincinati: U.S. Department of Health and Human Services—NIOSH; 1999.Google Scholar
- 4.Milczarek M, Schneider E, González E. OSH in figures: stress at work—facts and figures. Luxembourg: European Agency for Safety and Health at Work; 2009.Google Scholar
- 8.Vézina M Theorell T Brisson C. Le stress professionel: approche épidémiologique. In: Découverte L, (editor). Les risques au travail: pour ne pas perdre sa vie à la gagner; 2015.Google Scholar
- 9.Brisson C, Aboa-Eboulé C, Leroux I, Gilbert-Ouimet M, Vézina M, Bourbonnais R, et al. Psychosocial factors at work and heart disease. In: Allan R, editor. Heart & Mind: the evolution of cardiac psychology focused on clinical psychology. New-York: American Psychological Association; 2011.Google Scholar
- 10.Statistics Canada Table 13-10-0451-01 Health indicators, annual estimates, 2003–2014. 2015 [cited 2018 July 10]; Available from: https://www150.statcan.gc.ca/n1/en/catalogue/82-625-X
- 14.Dzau VJ, Antman EM, Black HR, Hayes DL, Manson JE, Plutzky J, et al. The cardiovascular disease continuum validated: clinical evidence of improved patient outcomes: part I: pathophysiology and clinical trial evidence (risk factors through stable coronary artery disease). Circulation. 2006;114(25):2850–70.CrossRefGoogle Scholar
- 24.• Banegas JR, Ruilope LM, de la Sierra A, Vinyoles E, Gorostidi M, de la Cruz JJ, et al. Relationship between clinic and ambulatory blood-pressure measurements and mortality. N Engl J Med. 2018;378(16):1509–20 Recent large-scale study showing a stronger effect of masked hypertension on CVD risk when compared to sustained hypertension.CrossRefGoogle Scholar
- 35.•• Dragano N, Siegrist J, Nyberg ST, Lunau T, Fransson EI, Alfredsson L, et al. Effort-reward imbalance at work and incident coronary heart disease: a multicohort study of 90,164 individuals. Epidemiology. 2017, 28;(4):619–26 Recent multi-cohort study showing an effect of both job strain and ERI exposures on incident coronary heart diseases.CrossRefGoogle Scholar
- 38.•• Sara JD, Prasad M, Eleid MF, Zhang M, Widmer RJ, Lerman A. Association between work-related stress and coronary heart disease: a review of prospective studies through the job strain, effort-reward balance, and organizational justice models. J Am Heart Assoc. 2018; 7 (9). Recent review on the effect of job strain, effort-reward imbalance, and organizational justice on coronary heart diseases. One strenght of this review is the inclusion of work stressors from three different models. Google Scholar
- 39.Vyas MV, Garg AX, Iansavichus AV, Costella J, Donner A, Laugsand LE, et al. Shift work and vascular events: systematic review and meta-analysis. BMJ. 2012;e4800:345.Google Scholar
- 40.•• Kivimaki M, Jokela M, Nyberg ST, Singh-Manoux A, Fransson EI, Alfredsson L, et al. Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603,838 individuals. Lancet. 2015;386(10005):1739–46 Recent multi-cohort study showing an effect of long working hours on cardiovascular diseases, which was more pronounced for stroke when compared to coronary heart diseases.CrossRefGoogle Scholar
- 47.Boucher P, Gilbert-Ouimet M, Trudel X, Duchaine CS, Milot A, Brisson C. Masked hypertension and effort-reward imbalance at work among 2369 white-collar workers. J Hum Hypertens. 2017.Google Scholar
- 53.•• Trudel X, Milot A, Gilbert-Ouimet M, Duchaine C, Guenette L, Dalens V, et al. Effort-reward imbalance at work and the prevalence of unsuccessfully treated hypertension among white-collar workers. Am J Epidemiol. 2017;186(4):456–62 This study showed an adverse effect of ERI exposure on blood pressure control among pharmacologically treated patients.CrossRefGoogle Scholar
- 62.Kivimaki M, Head J, Ferrie JE, Shipley MJ, Brunner E, Vahtera J, et al. Work stress, weight gain and weight loss: evidence for bidirectional effects of job strain on body mass index in the Whitehall II study. Int J Obes (Lond). 2006.Google Scholar
- 66.Brisson CG-O, M. Duchaine, C. Trudel X Vezina M Workplace interventions aiming to improve psychosocial work factors and related health. In: J. Siegrist, M. Wahrendorf, (editor). Work stress and health in a globalized economy. Switzerland: Springer; 2016. p. 333–364.Google Scholar
- 68.Egan M, Bambra C, Thomas S, Petticrew M, Whitehead M, Thomson H. The psychosocial and health effects of workplace reorganisation. 1. A systematic review of organisational-level interventions that aim to increase employee control. J Epidemiol Community Health. 2007;61(11):945–54.CrossRefGoogle Scholar
- 73.Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017;2017.Google Scholar
- 74.Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the task force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(28):2159–219.CrossRefGoogle Scholar
- 75.Chénard C, Mantha-Bélisle M-M, Vézina M. Risques psychosociaux du travail: des risques à la santé mesurables et modifiables. 2018 [cited 2018 July 10]; Available from: https://www.inspq.qc.ca/sites/default/files/publications/2373_risques_psychosociaux_travail_mesurables_modifiables.pdf