![Hidden hypertension: an unrecognized risk factor linked to stress at work](https://img.passeportsante.net/1000x526/2014-03-24/i49009-l-hypertension-cachee-un-facteur-de-risque-meconnu-lie-au-stress-au-travail.jpg)
Jan. 12, 2011 – Men who have stressful but stimulating jobs – which promote creativity, autonomy and decision-making – are more at risk of suffering from hidden hypertension.
Hidden hypertension is high blood pressure at work, but normal when you get home.
Researchers1 of Laval University have in fact established that workers with managerial functions or similar responsibilities would be twice as likely to develop hidden hypertension as workers in less demanding jobs.
Stress at work has already been shown to increase blood pressure and therefore the risk of hypertension. However, no study had established this link with hidden hypertension.
For this study, 2,357 white-collar workers working in 3 government agencies were recruited. The participants had to fill out a questionnaire to establish the psychological demand (volume of work, intellectual demands and production deadlines) and the decisional latitude (autonomy, participation in decisions, possibility of being creative and of developing one’s skills) of their job.
Hidden hypertension was assessed by measuring participants’ blood pressure using a hand-held device. This measurement was first taken when the device was installed, then every 15 minutes for at least 5 working hours. The researchers estimated that there was hidden hypertension when the measurements at the facility were below 140/90 mmHg and that the daily average pressure measured by the device during a work day exceeded 135/85 mmHg.
“Analysis of our data shows that men who have a stressful job combining high psychological demand and wide decision-making latitude are more prone to hidden hypertension,” said Xavier Trudel, lead author of the study and student researcher at doctorate at the Population Health Research Unit of the Faculty of Medicine.
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Xavier Trudel
The present results contradict the popular model that workers at risk for hidden hypertension are those who face high psychological demands, but little decision latitude. They also go against the idea that work that promotes personal development and control generates “positive” stress capable of mitigating the negative effects on health of demanding work.
“It is possible that the decision-making latitude is not enough to compensate for the strong psychological demand associated with demanding work,” explains Mr. Trudel, specifying that a longitudinal study is underway to clarify this point.
Risks to the heart
Hidden hypertension affects 15% of adult workers, study finds2 earlier carried out by the same team of researchers.
The cardiovascular risk in these is almost as high as in people whose hypertension is the subject of medical monitoring. It is more common in men and its prevalence increases in men with age and body mass index (BMI). In women, this prevalence would increase with BMI and alcohol consumption.
In the present study, no association between hidden hypertension and strenuous work was established in women. However, a link has been found with sustained hypertension. Marital demands and family responsibilities could interact with psychological demands at work, which would influence blood pressure measurement. Future research will attempt to clarify this point.
Hidden hypertension is difficult to measure in everyday life. It is only visible during working hours since once at home or in a doctor’s office, blood pressure is normal.
Measuring blood pressure at work?
The Dr Paul Lépine describes the study as “interesting” and “innovative”. “It is generally believed that a stressful but favorable job is not related to hypertension. Researchers have succeeded in showing that this pressure is nevertheless high at work and that it is linked to cardiovascular risk factors. This means that the apparently positive stress of a job can be negative, ”he comments.
According to Xavier Trudel, hidden hypertension must be recognized as a clinical entity so that people at risk can be targeted. A study is also underway on possible interventions in the workplace to discover psychosocial factors (for example, recognition, support from colleagues) that could help reduce hidden hypertension.
According to the Dr Lepine, nurses could take blood pressure in the workplace to detect people at risk.
Louis M. Gagné – PasseportSanté.net
1. Trudel X, Brisson C, Milot A, Job strain and masked hypertension. Psychosom Med. 2010 Oct; 72 (8): 786-93.
2. Trudel X, Brisson C, et al, Masked hypertension: different blood pressure measurement methodology and risk factors in a working population,. J Hypertens, 2009; 27: 1560-7.