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Int. J. Environ. Res. Public Health 2017, 14(4), 451; doi:10.3390/ijerph14040451

Job Strain and Casual Blood Pressure Distribution: Looking beyond the Adjusted Mean and Taking Gender, Age, and Use of Antihypertensives into Account. Results from ELSA-Brasil

1
National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480, Manguinhos, 21041-210 Rio de Janeiro, Rio de Janeiro, Brazil
2
Scientific Computing Program, Oswaldo Cruz Foundation, Avenida Brasil, 4365, Manguinhos, 21040-360 Rio de Janeiro, Rio de Janeiro, Brazil
3
Department of Physiological Sciences, Federal University of Espírito Santo, Avenida Marechal Campos, 1468, Maruípe, 29042-755 Vitória, Espírito Santo, Brazil
4
Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Avenida Brasil, 4365, Manguinhos, 21040-360 Rio de Janeiro, Rio de Janeiro, Brazil
*
Author to whom correspondence should be addressed.
Academic Editor: Harry H.X. Wang
Received: 23 November 2016 / Revised: 24 March 2017 / Accepted: 3 April 2017 / Published: 22 April 2017
(This article belongs to the Section Global Health)
View Full-Text   |   Download PDF [1937 KB, uploaded 22 April 2017]   |  

Abstract

Methodological issues are pointed to as the main sources of inconsistencies in studies about the association between job strain and blood pressure (BP)/hypertension. Our aim was to analyze the relationship between job strain and the whole BP distribution, as well as potential differences by gender, age, and use of antihypertensives. Additionally, we addressed issues relating to the operationalization of the exposure and outcome variables that influence the study of their inter-relations. We evaluated the baseline date of 12,038 participants enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) (2008–2010), a multicenter cohort study of 35–74-year-old civil servants. Job strain was assessed by the Demand-Control-Support Questionnaire. The distribution of casual BP by categories of job strain was compared by a combination of exploratory techniques. Participants were classified into three subgroups (normotensives, medicated hypertensives, and unmedicated hypertensives), and analyses were stratified by gender and age. The relationship between job strain and casual BP varied along the whole outcome distribution. Hypertensive participants had greater differences in casual BP by job strain category, especially medicated hypertensives. Differences in casual BP were also greater for systolic than for diastolic BP and for older participants. No differences were encountered by gender. The exclusion of participants susceptible to misclassification for the exposure and outcome variables increased the differences observed between the categories of low and high job strain. In conclusion, the relationship between job strain and casual BP varied along the whole outcome distribution and by use of antihypertensive drugs, age, and BP parameter evaluated. Misclassification for exposure and outcome variables should be considered in analyses of this topic. View Full-Text
Keywords: demand-control model; hypertension; job stress; method; psychosocial factor demand-control model; hypertension; job stress; method; psychosocial factor
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MDPI and ACS Style

Juvanhol, L.L.; Melo, E.C.P.; Carvalho, M.S.; Chor, D.; Mill, J.G.; Griep, R.H. Job Strain and Casual Blood Pressure Distribution: Looking beyond the Adjusted Mean and Taking Gender, Age, and Use of Antihypertensives into Account. Results from ELSA-Brasil. Int. J. Environ. Res. Public Health 2017, 14, 451.

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