Document Detail

Hypertension is not the link between job strain and coronary heart disease in the Whitehall II study.
MedLine Citation:
PMID:  17954359     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Hypertension is assumed to be one of the mechanisms through which job strain (a combination of high work demands and low job control) increases coronary heart-disease risk. However, direct tests of this hypothesis are lacking.
METHODS: We examined whether hypertension mediated the association between job strain and incident coronary heart disease among 5630 men and 2456 women free of coronary heart disease at study entry. Job strain was assessed at phase 1 (1985 to 1988); hypertension and systolic and diastolic blood pressure (BP) were assessed at phases 1, 3 (1992 to 1993), and 5 (1997 to 1999); and incident coronary heart disease was assessed from the end of phase 1 to phase 7 (2003 to 2004) (698 events; median follow-up, 16.1 years).
RESULTS: After adjustment for age, sex, ethnicity, and employment grade, job strain was associated with an increased incidence of coronary heart disease. Further adjustments, for hypertension, systolic BP, and diastolic BP at phase 1 and across phases 1, 3, and 5, and the slope of hypertension and BP over time, had little effect on this association, although measures of hypertension and BP were strongly related to incident coronary heart disease.
CONCLUSIONS: Data, including repeated casual measurements of hypertension and BP, suggest that the development of chronic hypertension is not a key mechanism linking job strain and coronary heart disease. Further research on ambulatory measurements is needed to determine whether episodic BP elevations have a role in this association.
Mika Kivimäki; Jenny Head; Jane E Ferrie; Martin J Shipley; Andrew Steptoe; Jussi Vahtera; Michael G Marmot
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of hypertension     Volume:  20     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-23     Completed Date:  2008-01-23     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1146-53     Citation Subset:  IM    
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MeSH Terms
Blood Pressure / physiology
Chronic Disease
Coronary Disease / epidemiology*
Great Britain / epidemiology
Hypertension / epidemiology*
Middle Aged
Occupations / statistics & numerical data*
Stress, Psychological / epidemiology*
Grant Support
AG13196/AG/NIA NIH HHS; G0100222//Medical Research Council; G19/35//Medical Research Council; G8802774//Medical Research Council; HL36310/HL/NHLBI NIH HHS; HS06516/HS/AHRQ HHS

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