累积工作紧张对四种职业人群血压影响的队列研究

Cohort study on effect of cumulative work stress on blood pressure in professional population

目的探讨累积工作紧张暴露对职业人群血压的影响。方法采用前瞻性队列研究方法,以上海市某城区四种职业的1 016名(男369、女647,年龄20~61岁)职业人群为调查对象。采用中文版工作内容问卷(JCQ)进行工作紧张评估,并对血压影响相关混杂因素进行调查。基线和随访均进行工作紧张评估和血压测量。采用协方差和多因素非条件Logistic回归分析工作紧张与血压的关系。结果在控制了可能影响血压的混杂因素后,以基线和随访均未暴露于工作紧张者组为对照,累积暴露工作紧张者收缩压上升3.80(95%CI 3.65~4.10)mm Hg;性别分层分析显示,男、女收缩压分别上升3.70(95%CI 3.25~4.16)、3.95(95%CI 3.62~4.28)mm Hg;舒张压升高无统计学意义。Logistic回归分析显示,累积工作紧张是四种职业人群收缩压升高独立危险因素,OR为1.83(95%CI 1.21~2.75),男、女OR值为分别为2.61(95%CI 1.24~5.31)、1.95(95%CI 1.05~3.66)。结论累积工作紧张可能是造成职业人群血压上升的社会心理因素之一,改善持续性工作紧张有助于防控职业人群因收缩压升高导致的收缩期高血压。

Objective To explore the effect of cumulative work stress exposure on blood pressure in professional population.Methods It was a prospective cohort study, the population was composed of 1 016 white-collar workers(369 men and 647 women, age 20—61),using Chinese version of Karasek’ s Job Content Questionnaire(JCQ)for the assessment of work stress, and the mean follow-up blood pressure values for each work stress and related confounding factors of blood pressure were investigated as well.Then the covariance analysis and multivariate unconditional Logistic regression were used to analyze the relationship between work stress and blood pressure.Results The results showed that after controlling all the confounding factors that may affect blood pressure, compared with the control group which was not exposed to work stress at baseline and follow-up, the cumulative work stress exposure group showed significant systolic blood pressure had 3.80(95% CI 3.65—4.10)mm Hg rise, male and female workers showed a significant systolic blood pressure increment: 3.70(95%CI 3.25—4.16)mm Hg and 3.95(95%CI 3.62—4.28)mm Hg, respectively, but there was no significant rise in diastolic blood pressure.The Logistic regression analysis showed that cumulative work stress is an independent risk factor for elevated systolic blood pressure in professional population, the relative risks(OR)was 1.83(95% CI 1.21—2.75),the OR for male and female was 2.61(95% CI 1.24—5.31)and 1.95(95% CI 1.05—3.66),respectively.Conclusion The results suggested that cumulative work stress may be one of the social psychological factors that cause the rise of blood pressure in professional workers, and the improvement of continuous work stress should be helpful in prevention and control of systolic hypertension caused by elevated systolic blood pressure in professional workers.