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Published in: International Archives of Occupational and Environmental Health 4/2011

01-04-2011 | Original Article

Association of occupation with prevalent hypertension in an elderly East German population: an exploratory cross-sectional analysis

Authors: Barbara Schumann, Andreas Seidler, Alexander Kluttig, Karl Werdan, Johannes Haerting, Karin Halina Greiser

Published in: International Archives of Occupational and Environmental Health | Issue 4/2011

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Abstract

Purpose

Hypertension is one of the most relevant risk factors for cardiovascular disease; however, little is known about differences in hypertension by occupation. The aim of this study was to explore the association between occupational group and prevalent hypertension.

Methods

Cross-sectional data of the CARLA study were used, a representative sample of an East German population aged 45–83. Job titles of the current or last held occupation of 967 men and 808 women were coded using the German classification of occupation. Hypertension was defined as blood pressure of ≥140 mmHg (systolic), ≥90 mmHg (diastolic) or use of antihypertensives. Sex-stratified, age-adjusted prevalence risk ratios (PR) with 95% confidence intervals (CI) were calculated for 31 occupational groups.

Results

Hypertension was prevalent in 79% of the population. In men, highest age-adjusted prevalence ratios were observed in metal-processing workers, carpenters/painters, and electricians with PRs of 1.31 (CI 1.04–1.65), 1.28 (CI 1.00–1.64), and 1.21 (0.95–1.53), respectively, compared to office clerks. In women, highest PRs were found in technicians/forewomen, scrutinisers/storekeepers, and food-processing occupations with PR 1.28 (1.09–1.49), 1.23 (0.99–1.51), and 1.22 (1.01–1.48), respectively. Adjustment for education, smoking, body mass index, and current work hours did not fully explain occupational differences. Excluding currently non-working subjects lead to decreased PRs in men and to increased PR in women.

Conclusions

Differences in the prevalences of hypertension by occupational group were only partly explained by conventional risk factors and may require workplace interventions targeted at high-risk occupations. Longitudinal data with large cohorts and work-related exposure assessment are needed to confirm a temporal relationship between occupation and incident hypertension.
Literature
go back to reference Barros AJ, Hirakata VN (2003) Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol 3:21CrossRef Barros AJ, Hirakata VN (2003) Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol 3:21CrossRef
go back to reference Belkic KL, Landsbergis PA, Schnall PL, Baker D (2004) Is job strain a major source of cardiovascular disease risk? Scand J Work Environ Health 30:85–128 Belkic KL, Landsbergis PA, Schnall PL, Baker D (2004) Is job strain a major source of cardiovascular disease risk? Scand J Work Environ Health 30:85–128
go back to reference Greiser KH, Kluttig A, Schumann B, Kors JA, Swenne CA, Kuss O, Werdan K, Haerting J (2005) Cardiovascular disease, risk factors and heart rate variability in the elderly general population: design and objectives of the CARdiovascular disease, Living and Ageing in Halle (CARLA) study. BMC Cardiovasc Disord 5:33. doi:10.1186/1471-2261-5-33 CrossRef Greiser KH, Kluttig A, Schumann B, Kors JA, Swenne CA, Kuss O, Werdan K, Haerting J (2005) Cardiovascular disease, risk factors and heart rate variability in the elderly general population: design and objectives of the CARdiovascular disease, Living and Ageing in Halle (CARLA) study. BMC Cardiovasc Disord 5:33. doi:10.​1186/​1471-2261-5-33 CrossRef
go back to reference Greiser KH, Kluttig A, Schumann B, Swenne CA, Kors JA, Kuss O, Haerting J, Schmidt H, Thiery J, Werdan K (2009) Cardiovascular diseases, risk factors and short-term heart rate variability in an elderly general population: the CARLA study 2002–2006. Eur J Epidemiol 24:123–142CrossRef Greiser KH, Kluttig A, Schumann B, Swenne CA, Kors JA, Kuss O, Haerting J, Schmidt H, Thiery J, Werdan K (2009) Cardiovascular diseases, risk factors and short-term heart rate variability in an elderly general population: the CARLA study 2002–2006. Eur J Epidemiol 24:123–142CrossRef
go back to reference Helmert U (1996) Kardiovaskuläre Risikofaktoren und Beruf: Resultate der Gesundheitssurveys der Deutschen Herz-Kreislauf-Präventionsstudie (Cardiovascular disease risk factors and occupation: Results of the German Cardiovascular Prevention Study). Soz Präventivmed 41:165–177CrossRef Helmert U (1996) Kardiovaskuläre Risikofaktoren und Beruf: Resultate der Gesundheitssurveys der Deutschen Herz-Kreislauf-Präventionsstudie (Cardiovascular disease risk factors and occupation: Results of the German Cardiovascular Prevention Study). Soz Präventivmed 41:165–177CrossRef
go back to reference Hense HW, Filipiak B, Döring A, Stieber J, Liese A, Keil U (1998) Ten-year trends of cardiovascular risk factors in the MONICA Augsburg Region in Southern Germany. Results from the 1984/1985, 1989/1990 and 1994/1995 surveys. CVD Prevention 1:318–327 Hense HW, Filipiak B, Döring A, Stieber J, Liese A, Keil U (1998) Ten-year trends of cardiovascular risk factors in the MONICA Augsburg Region in Southern Germany. Results from the 1984/1985, 1989/1990 and 1994/1995 surveys. CVD Prevention 1:318–327
go back to reference John U, Greiner B, Hensel E, Ludemann J, Piek M, Sauer S, Adam C, Born G, Alte D, Greiser E, Haertel U, Hense HW, Haerting J, Willich S, Kessler C (2001) Study of Health in Pomerania (SHIP): a health examination survey in an east German region: objectives and design. Soz Praventivmed 46:186–194CrossRef John U, Greiner B, Hensel E, Ludemann J, Piek M, Sauer S, Adam C, Born G, Alte D, Greiser E, Haertel U, Hense HW, Haerting J, Willich S, Kessler C (2001) Study of Health in Pomerania (SHIP): a health examination survey in an east German region: objectives and design. Soz Praventivmed 46:186–194CrossRef
go back to reference Kivimäki M, Virtanen M, Elovainio M, Kouvonen A, Väänänen A, Vahtera J (2006) Work stress in the etiology of coronary heart disease–a meta-analysis. Scand J Work Environ Health 32:431–442 Kivimäki M, Virtanen M, Elovainio M, Kouvonen A, Väänänen A, Vahtera J (2006) Work stress in the etiology of coronary heart disease–a meta-analysis. Scand J Work Environ Health 32:431–442
go back to reference Kosnett MJ, Wedeen RP, Rothenberg SJ, Hipkins KL, Materna BL, Schwartz BS, Hu H, Woolf A (2007) Recommendations for medical management of adult lead exposure. Environ Health Perspect 115:463–471CrossRef Kosnett MJ, Wedeen RP, Rothenberg SJ, Hipkins KL, Materna BL, Schwartz BS, Hu H, Woolf A (2007) Recommendations for medical management of adult lead exposure. Environ Health Perspect 115:463–471CrossRef
go back to reference Lee J (1994) Odds ratio or relative risk for cross-sectional data? Int J Epidemiol 23:201–203CrossRef Lee J (1994) Odds ratio or relative risk for cross-sectional data? Int J Epidemiol 23:201–203CrossRef
go back to reference Lee J, Chia KS (1993) Estimation of prevalence rate ratios for cross sectional data: an example in occupational epidemiology. Br J Ind Med 50:861–862 Lee J, Chia KS (1993) Estimation of prevalence rate ratios for cross sectional data: an example in occupational epidemiology. Br J Ind Med 50:861–862
go back to reference Leigh JP, Du J (2009) Hypertension and occupation among seniors. J Occup Environ Med 51:661–671CrossRef Leigh JP, Du J (2009) Hypertension and occupation among seniors. J Occup Environ Med 51:661–671CrossRef
go back to reference Marmot MG, Smith GD, Stansfeld S, Patel C, North F, Head J, White I, Brunner E, Feeney A (1991) Health inequalities among British civil servants: the Whitehall II study. Lancet 337:1387–1393CrossRef Marmot MG, Smith GD, Stansfeld S, Patel C, North F, Head J, White I, Brunner E, Feeney A (1991) Health inequalities among British civil servants: the Whitehall II study. Lancet 337:1387–1393CrossRef
go back to reference McFadden E, Luben R, Wareham N, Bingham S, Khaw KT (2008) Occupational social class, risk factors and cardiovascular disease incidence in men and women: a prospective study in the European Prospective Investigation of Cancer and Nutrition in Norfolk (EPIC-Norfolk) cohort. Eur J Epidemiol 23:449–458CrossRef McFadden E, Luben R, Wareham N, Bingham S, Khaw KT (2008) Occupational social class, risk factors and cardiovascular disease incidence in men and women: a prospective study in the European Prospective Investigation of Cancer and Nutrition in Norfolk (EPIC-Norfolk) cohort. Eur J Epidemiol 23:449–458CrossRef
go back to reference Nurminen M, Karjalainen A (2001) Epidemiologic estimate of the proportion of fatalities related to occupational factors in Finland. Scand J Work Environ Health 27:161–213 Nurminen M, Karjalainen A (2001) Epidemiologic estimate of the proportion of fatalities related to occupational factors in Finland. Scand J Work Environ Health 27:161–213
go back to reference Seidler A, Geller P, Nienhaus A, Bernhardt T, Ruppe I, Eggert S, Hietanen M, Kauppinen T, Frölich L (2007) Occupational exposure to low frequency magnetic fields and dementia: a case-control study. Occup Environ Med 64:108–114CrossRef Seidler A, Geller P, Nienhaus A, Bernhardt T, Ruppe I, Eggert S, Hietanen M, Kauppinen T, Frölich L (2007) Occupational exposure to low frequency magnetic fields and dementia: a case-control study. Occup Environ Med 64:108–114CrossRef
go back to reference Siegrist J, Starke D, Chandola T, Godin I, Marmot M, Niedhammer I, Peter R (2004) The measurement of effort–reward imbalance at work: European comparisons. Soc Sci Med 58:1483–1499CrossRef Siegrist J, Starke D, Chandola T, Godin I, Marmot M, Niedhammer I, Peter R (2004) The measurement of effort–reward imbalance at work: European comparisons. Soc Sci Med 58:1483–1499CrossRef
go back to reference Statistisches Bundesamt (1992) Klassifikation der Berufe—Systematisches und alphabetisches Verzeichnis der Berufsbenennungen—Ausgabe 1992 (Classification of occupations—Systematic and alphabetical index of job titles—Edition 1992). Metzler-Poeschel, Stuttgart Statistisches Bundesamt (1992) Klassifikation der Berufe—Systematisches und alphabetisches Verzeichnis der Berufsbenennungen—Ausgabe 1992 (Classification of occupations—Systematic and alphabetical index of job titles—Edition 1992). Metzler-Poeschel, Stuttgart
go back to reference Steenland K, Fine L, Belkić K, Landsbergis P, Schnall P, Baker D, Theorell T, Siegrist J, Peter R, Karasek R, Marmot M, Brisson C, Tüchsen F (2000) Research findings linking workplace factors to CVD outcomes. Occup Med 15:7–68 Steenland K, Fine L, Belkić K, Landsbergis P, Schnall P, Baker D, Theorell T, Siegrist J, Peter R, Karasek R, Marmot M, Brisson C, Tüchsen F (2000) Research findings linking workplace factors to CVD outcomes. Occup Med 15:7–68
go back to reference Suwazono Y, Dochi M, Sakata K, Okubo Y, Oishi M, Tanaka K, Kobayashi E, Nogawa K (2008) Shift work is a risk factor for increased blood pressure in Japanese men: a 14-year historical cohort study. Hypertension 52:581–586CrossRef Suwazono Y, Dochi M, Sakata K, Okubo Y, Oishi M, Tanaka K, Kobayashi E, Nogawa K (2008) Shift work is a risk factor for increased blood pressure in Japanese men: a 14-year historical cohort study. Hypertension 52:581–586CrossRef
go back to reference Thamm M (1999) Blutdruck in Deutschland—Zustandsbeschreibung und Trends (Blood pressure in Germany—Description of situation and trends). Gesundheitswesen (Sonderheft 2): S90–S93 Thamm M (1999) Blutdruck in Deutschland—Zustandsbeschreibung und Trends (Blood pressure in Germany—Description of situation and trends). Gesundheitswesen (Sonderheft 2): S90–S93
go back to reference Van Kempen EE, Kruize H, Boshuizen HC, Ameling CB, Staatsen BA, de Hollander AE (2002) The association between noise exposure and blood pressure and ischemic heart disease: a meta-analysis. Environ Health Perspect 110:307–317CrossRef Van Kempen EE, Kruize H, Boshuizen HC, Ameling CB, Staatsen BA, de Hollander AE (2002) The association between noise exposure and blood pressure and ischemic heart disease: a meta-analysis. Environ Health Perspect 110:307–317CrossRef
go back to reference Wacholder S (1986) Binomial regression in GLIM: estimating risk ratios and risk differences. Am J Epidemiol 123:174–184 Wacholder S (1986) Binomial regression in GLIM: estimating risk ratios and risk differences. Am J Epidemiol 123:174–184
go back to reference Wolf-Maier K, Cooper RS, Banegas JR, Giampaoli S, Hense HW, Joffres M, Kastarinen M, Poulter N, Primatesta P, Rodríguez-Artalejo F, Stegmayr B, Thamm M, Tuomilehto J, Vanuzzo D, Vescio F (2003) Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA 289:2363–2369CrossRef Wolf-Maier K, Cooper RS, Banegas JR, Giampaoli S, Hense HW, Joffres M, Kastarinen M, Poulter N, Primatesta P, Rodríguez-Artalejo F, Stegmayr B, Thamm M, Tuomilehto J, Vanuzzo D, Vescio F (2003) Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA 289:2363–2369CrossRef
go back to reference Wolf-Maier K, Cooper RS, Kramer H, Banegas JR, Giampaoli S, Joffres MR, Poulter N, Primatesta P, Stegmayr B, Thamm M (2004) Hypertension treatment and control in five European countries, Canada, and the United States. Hypertension 43:10–17CrossRef Wolf-Maier K, Cooper RS, Kramer H, Banegas JR, Giampaoli S, Joffres MR, Poulter N, Primatesta P, Stegmayr B, Thamm M (2004) Hypertension treatment and control in five European countries, Canada, and the United States. Hypertension 43:10–17CrossRef
Metadata
Title
Association of occupation with prevalent hypertension in an elderly East German population: an exploratory cross-sectional analysis
Authors
Barbara Schumann
Andreas Seidler
Alexander Kluttig
Karl Werdan
Johannes Haerting
Karin Halina Greiser
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
International Archives of Occupational and Environmental Health / Issue 4/2011
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI
https://doi.org/10.1007/s00420-010-0584-5

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