The effect on ambulatory blood pressure of working under favourably and unfavourably perceived supervisors (original) (raw)
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Organisational injustice and impaired cardiovascular regulation among female employees
Occupational and Environmental Medicine, 2006
Objectives: To examine the relation between perceived organisational justice and cardiovascular reactivity in women. Methods: The participants were 57 women working in long term care homes. Heart rate variability and systolic arterial pressure variability were used as markers of autonomic function. Organisational justice was measured using the scale of Moorman. Data on other risk factors were also collected. Results: Results from logistic regression models showed that the risk for increased low frequency band systolic arterial pressure variability was 3.8-5.8 times higher in employees with low justice than in employees with high justice. Low perceived justice was also related to an 80% excess risk of reduced high frequency heart rate variability compared to high perceived justice, but this association was not statistically significant.
Objective To explore associations between self-reported hypertension and workplace psychosocial factors that are common among U.S. workers and to identify industries and occupations (I&Os) that are associated with a high prevalence of hypertension, even after adjustment for common known risk factors. Methods Data from the 2010 National Health Interview Survey were used to examine relationships between the prevalence of self-reported hypertension and job insecurity, hostile work environment, work- family imbalance, work hours and I&O. Results: Job insecurity (adjusted prevalence ratio (aPR): 1.11; 95% confidence interval (CI): 1.04–1.19)) and hostile work environment (aPR: 1.15; 95% CI: 1.03–1.29) were significantly associated with hypertension. Hypertension prevalence was significantly elevated among those employed in Healthcare Support occupations and Public Administration industries. Conclusion Addressing hostile work environments and the stress associated with job insecurity may improve workers’ health. Other occupational factors that contribute to the variation in prevalence of hypertension by I&O should be sought.
Psychosomatic Medicine, 2008
Objective: To examine whether lower BP mediates the inverse association between organizational justice and incident coronary heart disease (CHD). Previous studies suggest lower blood pressure (BP) and reduced risk of CHD among employees with high organizational justice (the perception of being treated fairly by supervisors). Methods: Prospective occupational cohort study of 4250 men and 1812 women free of CHD and hypertension at study entry (the Whitehall II study). Justice was assessed at phase 1 (1985)(1986)(1987)(1988) and phase 2 (1989 -1990); systolic and diastolic BP at phases 1, 3 (1992-1993), and 5 (1997-1999); hypertension at phases 3 and 5; and incident CHD from phase 2 to phase 5 (231 events, mean follow-up 9.6 years). Results: A higher level of organizational justice was associated with a slightly lower mean level of diastolic BP over time. After adjustment for age, sex, ethnicity, and employment grade, higher organizational justice was associated with lower CHD incidence. This association was not attenuated after further adjustment for measures of BP and hypertension, although these measures were associated with increased CHD risk. Conclusions: This study suggests that sustained lower levels of BP do not represent a key mechanism through which organizational justice protects against CHD. The importance of this study is that it eliminates a strong candidate mediator of the association between organizational justice and CHD and thus allows future research to concentrate on other mechanisms.
Psychosocial work environment and the risk of coronary heart disease
International Archives of Occupational and Environmental Health, 2000
Objectives: Remarkable changes in the working situation have led to the increasing importance of psychomentally and socio-emotionally demanding conditions at work. With the help of theoretical models, those highly prevalent psychosocial work environments were conceptualized which in¯uence the risk of coronary heart disease by enhanced activation of the autonomic nervous system. One of the most prominent theoretical approaches, the job strain model, and a more recent approach, the eort-reward imbalance model, are discussed in the paper. Empirical evidence: Findings from prospective and cross-sectional studies indicate that job strain and eort-reward imbalance at work de®ne spe-ci®c conditions of chronic work stress that are associated with an elevated risk of coronary heart disease (CHD). Respective multivariate odds-ratios range from 1.2 to 5.0 with respect to job strain, and from 1.5 to 6.1 with respect to eort-reward imbalance. These associations are explained neither by established behavioral or biomedical risk factors nor by physical and chemical hazards at work, rather they de®ne independent, new work-related risk conditions. There is additional evidence that eort-reward imbalance may mediate the association of some traditional occupational exposures, such as shift work, with cardiovascular risk: in a crosssectional study, prevalence odds ratios of hypertension and atherogenic lipids attributable to eort-reward imbalance were relatively highest among shiftworkers as compared to daytime workers. Preliminary results from intervention programs based on the theoretical models document favorable eects on health. Conclusions: Information derived from theoretical models on psychosocial work environment may help to better identify populations at risk and to develop and apply speci®c, theory-guided preventive activities in the future.
Perceived Job Stress and Presence of Hypertension Among Administrative Officers in Sri Lanka
Asia-Pacific journal of public health / Asia-Pacific Academic Consortium for Public Health, 2015
A cross-sectional survey was carried out among 275 and 760 randomly selected senior officers (SOs) and managerial assistants (MAs) aged between 30 and 60 years. Sum of scores of efforts, rewards, and overcommitment and effort-reward ratio assessed job stress. Blood pressure was measured and classified using JNC-7 guidelines. The response rates of SOs and MAs were 98.9% and 97.2%, respectively. The prevalence of job stress based on high effort-rewards imbalance among SOs and MAs was 74.6% and 80.5%, respectively. The prevalence of overcommitment among SOs and MAs was 35.3% and 29%, respectively. Statistically significant differences (P = .05) were observed between the prevalence of effort-reward imbalance and overcommitment among SOs and MAs. Multivariate analysis indicated effort-reward imbalance (odds ratio [OR] = 2.8; 95% confidence interval [CI] = 1.1-7.4), high efforts (OR = 2.5; 95% CI = 1.2-5.3), and overcommitment (OR = 2.5; 95% CI = 1.1-5.6) were significantly associated wit...
Stress Management at the Worksite: Reversal of Symptoms Profile and Cardiovascular Dysregulation
Hypertension, 2006
Work stress may increase cardiovascular risk either indirectly, by inducing unhealthy life styles, or directly, by affecting the autonomic nervous system and arterial pressure. We hypothesized that, before any apparent sign of disease, work-related stress is already accompanied by alterations of RR variability profile and that a simple onsite stress management program based on cognitive restructuring and relaxation training could reduce the level of stress symptoms, revert stress-related autonomic nervous system dysregulation, and lower arterial pressure. We compared 91 white-collar workers, enrolled at a time of work downsizing (hence, in a stress condition), with 79 healthy control subjects. Psychological profiles were assessed by questionnaires and autonomic nervous system regulation by spectral analysis of RR variability. We also tested a simple onsite stress management program (cognitive restructuring and relaxation training) in a subgroup of workers compared with a sham subgroup (sham program). Workers presented an elevated level of stress-related symptoms and an altered variability profile as compared with control subjects (low-frequency component of RR variability was, respectively, 65.2Ϯ2 versus 55.3Ϯ2 normalized units; PϽ0.001; opposite changes were observed for the high-frequency component). These alterations were largely reverted (low-frequency component of RR variability from 63.6Ϯ3.9 to 49.3Ϯ3 normalized units; PϽ0.001) by the stress management program, which also slightly lowered systolic arterial pressure. No changes were observed in the sham program group. This noninvasive study indicates that work stress is associated with unpleasant symptoms and with an altered autonomic profile and suggests that a stress management program could be implemented at the worksite, with possible preventive advantages for hypertension. (Hypertension. 2007;49:291-297.)
Blood Pressure and Emotional Health in Hypertensive Employees
2015
Objectives: This study examined the impact of a workplace-based stress management pro-gram on blood pressure (BP), emotional health, and workplace-related measures in hyperten-sive employees of a global information technology company. Design: Thirty-eight (38) employees with hypertension were randomly assigned to a treatment group that received the stress-reduction intervention or a waiting control group that received no intervention during the study period. The treatment group participated in a 16-hour program, which included instruction in positive emotion refocusing and emotional restructuring techniques intended to reduce sympathetic nervous system arousal, stress, and negative affect, increase pos-itive affect, and improve performance. Learning and practice of the techniques was enhanced by heart rate variability feedback, which helped participants learn to self-generate physiological co-herence, a beneficial physiologic mode associated with increased heart rhythm coherence, ph...
Association between ambulatory blood pressure and alternative formulations of job strain
Scandinavian Journal of Work, Environment & Health, 1994
OBJECfIVES-The goal of the study was to determine whether alternative formulations of Karasek & Theorell' s job-strain construct are associated with ambulatory blood pressure and the risk of hypertension. M~;THODS-Full-time male employees (N = 262) in eight worksites completed a casual blood pressure screening, medical examinations, and questionnaires and wore an ambulatory blood pressure monitor for 24 h on a workday. Cases of hypertension were ascertained from casual blood pressure readings for a case-referent analysis. A cross-sectional analysis was also conducted, ambulatory (continuous) blood pressure measurements being used as the outcome. RESULTS-All formulations of job strain exhibited significant associations with systolic blood pressure at work and home, but not with diastolic blood pressure. Employees experiencing job strain had a systolic blood pressure that was 6.7 mm Hg (~0. 8 9 kPa) higher and a diastolic blood pressure that was 2.7 mm Hg (~0.3 6 kPa) higher at work than other employees, and the odds of hypertension were increased [odds ratio (OR) 2.9, 95% confidence interval (95% CI) 1.3-6.6]. Using national means for decision latitude and demands to define job strain increased the systolic and diastolic blood pressure associations to 11.5 mm Hg (~1.5 3 kPa) and 4.1 mm Hg (~0. 54 kPa), respectively. Adding organizational influence to the task-level decision latitude variable produced a stronger association for hypertension with job strain (OR 3.7,95% CI 1.6-8.5). Adding social support to the job-strain model also slightly increased the hypertension risk. CONCLUSIONS-The impact of job strain, at least on systolic blood pressure, is consistent and robust across alternative formulations, more restrictive cut points tending to produce stronger effects. KEY TERMS-hypertension, job strain, occupation, social support, stress. One of the most influential model s of the health effe ct s of work-related stress is Karasek & Theorell's "job strain" model. According to the model, the greates t ris k of illness due to stress occurs to workers facin g job str ain, defined as a co mbinatio n of high work-load demands and low job-decision latitude or lo w j ob contro l. Over 30 studies have been published on the as sociation between job strain and cardiovascular dise ase (CVO) or CVO risk factors (I, 2). Mo st ha ve found a pos itive association between job strain and outcome. Of six cohort studies of CVO (3-8) and two cohort studies of all-cause mortality (9, 10), seven found significant po siti ve associations (3-7, 9,10).