Blood Pressure

“In a review conducted in 2000, a majority of the 11 cross-sectional studies of job strain (or its components) and ABP (Ambulatory Blood Pressure) among men found a relationship between job strain and higher work ABP [56]. In the five studies where ABP measurements were also made outside of work, men with job strain also had higher non-work systolic ABP, showing that the impact of job strain on ABP occurred across the whole day and night. Of the six cross-sectional studies of job strain and ABP among women published by 2000, four showed that women with job strain had higher work systolic ABP [94]. Workers with job strain typically have about 4-8 mm Hg higher work systolic ABP than those without job strain. The only longitudinal (long-term) study of job strain and ABP, the New York City Work Site Blood Pressure Study (WSBPS), began in 1985. At the first round of data collection (Time 1), men with job strain showed increases in the size of their heart’s left ventricle, a sign of damage to the heart [95], and had higher levels of work, home, and sleep ABP, after taking into account other risk factors, such as age, race, and weight, than men without job strain [96, 97]. These findings were recently replicated by the Belgian Job Stress Project [98]. Since the study participants returned 3 years later (Time 2), had their BP measured, and completed questionnaires about their jobs, it was possible to create a measure of chronic or longer-term exposure to job strain. Men facing job strain at both Time 1 and Time 2 (longer-term exposure) had an 11-12 mm Hg higher systolic and 6-9 mm Hg higher diastolic work ABP than men not facing job strain at either time. This difference is substantial, more than twice the difference between African Americans and whites in this sample and more than the effect on BP in this study sample of aging 25 years or gaining 50 pounds in weight [99]. To give an idea of the potential benefit of leaving a situation of job strain, those men reporting job strain at Time 1 but no job strain at Time 2 showed a drop in blood pressure 5.3 mm Hg systolic ABP at work and 4.7 mm Hg systolic ABP at home [99].”


Taken from: Schnall PL, Dobson M, Rosskam E, Editors Unhealthy Work: Causes, Consequences, Cures. Baywood Publishing, 2009.

56. Belkic, K., P. A. Landsbergis, P. Schnall, et al., Psychosocial Factors: Review of the Empirical Data among Men, in The Workplace and Cardiovascular Disease Occu- pational Medicine: State of the Art Reviews, Schnall, P., K. Belkic, P. A. Landsbergis, and D. Baker (eds.), Hanley and Belfus, Philadelphia, PA, pp. 24-46, 2000.

94. Brisson, C., Women, Work and Cardiovascular Disease, in The Workplace and Cardiovascular Disease Occupational Medicine: State of the Art Reviews, Schnall, P., K. Belkic, P. A. Landsbergis, and D. E. Baker (eds.), Hanley and Belfus, Philadelphia, pp. 49-57, 2000.

95. Schnall, P. L., C. Pieper, J. E. Schwartz, et al., The Relationship between ‘Job Strain,’ Workplace Diastolic Blood Pressure, and Left Ventricular Mass Index. Results of a Case-Control Study [published erratum appears in JAMA 1992 Mar 4;267(9):1209], Journal of the American Medical Association, 263:14, pp. 1929-1935, 1990.

96. Landsbergis, P. A., P. L. Schnall, K. Warren, T. G. Pickering, and J. E. Schwartz, Association between Ambulatory Blood Pressure and Alternative Formulations of Job Strain, Scandinavian Journal of Work, Environment and Health, 20:5, pp. 349-363, 1994.

97. Schnall, P. L., J. E. Schwartz, P. A. Landsbergis, K. Warren, and T. G. Pickering, Relation between Job Strain, Alcohol, and Ambulatory Blood Pressure, Hypertension, 19, pp. 488-494, 1992.

98. Clays, E., F. Leynen, D. De Bacquer, et al., High Job Strain and Ambulatory Blood Pressure in Middle-Aged Men and Women from the Belgian Job Stress Study, Journal of Occupational and Environmental Medicine, 49, pp. 360-367, 2007.

99. Schnall, P. L., P. A. Landsbergis, J. Schwartz, K. Warren, and T. G. Pickering, A Longitudinal Study of Job Strain and Ambulatory Blood Pressure: Results from a Three-Year Follow-Up, Psychosomatic Medicine, 60, pp. 697-706, 1998.

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