Occupational stress and hypertension

Work hours and the risk of hypertension: the case of Indonesia

BACKGROUND

Individuals working excessive hours is a worldwide phenomenon. In Indonesia, over 32 million people work more than 40 h per week, contributing to around 26% of the workforce. Excessive working may affect health, increasing the risk of cardiovascular diseases such as hypertension. Hypertension affected around 34% of Indonesian adults, approximately 63.3 million people and led to about 427,000 deaths in 2018, and the prevalence remains high at 29.2% in 2023. This study aims to analyze the relationship between work hours and the risk of hypertension among working individuals in Indonesia.

METHODS

This study used a pooled cross-sectional data from the Indonesian Family Life Survey (IFLS) wave 4 (2007) and wave 5 (2014) and performed a logit regression analysis to examine the likelihood of a working individual having hypertension based on the individual's work hours. A dummy variable of hypertension is created based on the result of blood pressure measurement. The sample consists of 22,500 working individuals in Indonesia. This study controlled for job characteristics, sociodemographic status and health-behavioral risk factors such as BMI and smoking behavior, and performed additional regression analyses for alternative models to check for robustness.

RESULTS

Our findings showed that there is a higher probability of having hypertension for workers who work longer hours by 0.06% points for each additional hour of work (p < 0.01). Other factors such as physical activity and smoking behavior have also been demonstrated to be significantly correlated to the risk of hypertension.

CONCLUSIONS

This study revealed a positive relationship between work hours and hypertension. Although this study cannot suggest causality, the strongly significant correlation may provide an idea and an overview regarding the risk of hypertension among working individuals in Indonesia. The Indonesian government could consider conducting further studies to implement and promote flexible working arrangements initiatives and incentive programs to improve workers' health outcomes.

The effects of jujube (Ziziphus jujube) on metabolic and mental health outcomes in patients with metabolic syndrome: A randomized controlled trial

OBJECTIVES

The effects of jujube (Ziziphus jujube) consumption on metabolic and mental health outcomes in subjects diagnosed with metabolic syndrome (MetS) is unknown and remains to be examined. Hence, we carried out a parallel-group, randomized controlled trial to investigate this issue.

METHODS

Eligible participants were randomly assigned to the intervention (n = 30) or the control (n = 30) groups to receive either jujube or a placebo for eight weeks. Subjects were provided with 30 g dried jujube powder or placebo and were asked to consume half of the powder at 10 a.m. and the rest at 4 p.m. Lipid profile, fasting blood glucose (FBG), waist circumference (WC), and blood pressure were evaluated as primary outcomes. Secondary outcomes collected were mental health measures (e.g., depression, anxiety, and stress).

RESULTS

Jujube consumption failed to decrease FBG, total cholesterol, low-density lipoprotein cholesterol, and blood pressure, as well as depression and anxiety scores (P > 0.05). However, the between-group comparison revealed a significant improvement in WC (- 3.98 vs. - 0.51, P = 0.01), triglyceride (TG) (- 24.96 vs. - 0.73, P = 0.03), and high-density lipoprotein cholesterol (HDL-C) (2.83 vs. 0.40, P = 0.01) in the jujube group compared to the placebo. In addition, compared to the control group, jujube consumption led to a significant improvement in the score of stress (- 5.80 vs. - 2.86, P = 0.01).

CONCLUSION

Jujube consumption only had beneficial effects on WC, TG, and HDL-C in subjects with MetS. However, the current study has methodological weaknesses in blinding and herb purity/potency testing, which should be addressed in future studies.

An urgent call to address work-related psychosocial hazards and improve worker well-being

Work-related psychosocial hazards are on the verge of surpassing many other occupational hazards in their contribution to ill-health, injury, disability, direct and indirect costs, and impact on business and national productivity. The risks associated with exposure to psychosocial hazards at work are compounded by the increasing background prevalence of mental health disorders in the working-age population. The extensive and cumulative impacts of these exposures represent an alarming public health problem that merits immediate, increased attention. In this paper, we review the linkage between work-related psychosocial hazards and adverse effects, their economic burden, and interventions to prevent and control these hazards. We identify six crucial societal actions: (1) increase awareness of this critical issue through a comprehensive public campaign; (2) increase etiologic, intervention, and implementation research; (3) initiate or augment surveillance efforts; (4) increase translation of research findings into guidance for employers and workers; (5) increase the number and diversity of professionals skilled in preventing and addressing psychosocial hazards; and (6) develop a national regulatory or consensus standard to prevent and control work-related psychosocial hazards.

Correlation analysis between occupational stress and metabolic syndrome in workers of a petrochemical enterprise: based on two assessment models of occupational stress

BACKGROUND

Occupational stress is becoming a common phenomenon around the world. Being in a high occupational stress state for a long time may destroy the metabolic balance of the body, thereby increasing the risk of metabolic diseases. There is limited evidence regarding the correlation between occupational stress and metabolic syndrome (MetS), particularly in the petrochemical workers.

METHODS

A total of 1683 workers of a petrochemical enterprise in China were included in the survey by cluster sampling method. The occupational stress assessment was carried out by the Job Content Questionnaire and the Effort-Reward Imbalance Questionnaire, and the general demographic characteristics, work characteristics, occupational hazards, lifestyle and health examination data of the participants were collected. Logistic regression and multiple linear regression were used to analyze the correlations and influencing factors between occupational stress and its dimensions with MetS and its components.

RESULTS

A total of 1683 questionnaires were sent out, and 1608 were effectively collected, with an effective recovery rate of 95.54%. The detection rates of occupational stress in Job Demand-Control (JDC) and Effort-Reward Imbalance (ERI) models were 28.4% and 27.2%, respectively. In this study, 257 participants (16.0%) were diagnosed with MetS. Compared with the non-MetS group, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG) and fasting blood-glucose (FBG) levels were significantly higher in the MetS group, and high density lipoprotein-cholesterol (HDL-C) levels were significantly lower (P < 0.001). The results of multiple linear regression showed that after adjusting for nation, marital status, education, work system, smoking and drinking, and further adjusting for occupational hazards, the D/C ratio was significantly negatively correlated with SBP in the JDC model. Social support was negatively correlated with WC. In the ERI model, there was a significant positive correlation between over-commitment and FBG.

CONCLUSIONS

The detection rates of occupational stress and MetS were high in workers of a petrochemical enterprise. In the JDC model, occupational stress was negatively correlated with SBP, and social support was negatively correlated with WC. In the ERI model, there was a significantly positive correlation between over-commitment and FBG.

The Interaction between Stress and Inflammatory Bowel Disease in Pediatric and Adult Patients

Background: Inflammatory bowel diseases (IBDs) have seen an exponential increase in incidence, particularly among pediatric patients. Psychological stress is a significant risk factor influencing the disease course. This review assesses the interaction between stress and disease progression, focusing on articles that quantified inflammatory markers in IBD patients exposed to varying degrees of psychological stress. Methods: A systematic narrative literature review was conducted, focusing on the interaction between IBD and stress among adult and pediatric patients, as well as animal subjects. The research involved searching PubMed, Scopus, Medline, and Cochrane Library databases from 2000 to December 2023. Results: The interplay between the intestinal immunity response, the nervous system, and psychological disorders, known as the gut-brain axis, plays a major role in IBD pathophysiology. Various types of stressors alter gut mucosal integrity through different pathways, increasing gut mucosa permeability and promoting bacterial translocation. A denser microbial load in the gut wall emphasizes cytokine production, worsening the disease course. The risk of developing depression and anxiety is higher in IBD patients compared with the general population, and stress is a significant trigger for inducing acute flares of the disease. Conclusions: Further large studies should be conducted to assess the relationship between stressors, psychological disorders, and their impact on the course of IBD. Clinicians involved in the medical care of IBD patients should aim to implement stress reduction practices in addition to pharmacological therapies.

Blood pressure responses are dependent on call type and related to hypertension status in firefighters

BACKGROUND

Impaired cardiovascular health is a concern for firefighters, with over 50% of line-of-duty deaths having cardiac causes. Many firefighters have hypertension and <25% have their blood pressure (BP) controlled. The alarm response could be an unidentified cardiac risk, but interestingly, the BP response to different calls and on-the-job activity is unknown.

PURPOSE

We aimed to measure the physiological stress resulting from different call types (fire, medical) and job activity (riding apparatus, pre-alert alarms) through ambulatory BP (ABP) monitoring in a population of firefighters.

MATERIALS AND METHODS

During 111 12-h work shifts firefighters wore an ABP monitor. BP was measured at 30-min intervals and manual measurements were prompted when the pager went off or whenever they felt stress.

RESULTS

Firefighters were hypertensive (124.3 ± 9.9/78.1 ± 6.7 mmHg), overweight (30.2 ± 4.6 kg/m2), middle-aged (40.5 ± 12.6 years) and experienced (17.3 ± 11.7 years). We calculated an average 11% increase in systolic and 10.5% increase in diastolic BP with alarm. Systolic BP (141.9 ± 13.2 mmHg) and diastolic BP (84.9 ± 11.1 mmHg) and the BP surges were higher while firefighters were responding to medical calls compared to fire calls. Between BP groups we found that medical call systolic BP (p = .001, d = 1.2), diastolic BP (p = .017, d = 0.87), and fire call systolic BP (p = .03, d = 0.51) levels were higher in the hypertensive firefighters.

CONCLUSION

This is the first report of BP surge responses to alarms and to occupational activities in firefighters, and medical calls elicited the largest overall responses.PLAIN LANGUAGE SUMMARYCardiovascular disease and impaired cardiovascular health are substantially more prevalent in firefighters, with over 50% of line-of-duty deaths being cardiac related.Many firefighters are diagnosed with high blood pressure (hypertension), which is known to increase the risk of heart attacks, strokes, heart disease, and other serious health complications.Upon stress, our body enacts the 'fight or flight' response where sympathetic nervous system activity triggers an immediate increase in heart rate and blood pressure. This response can be dangerous when surges reach extreme levels due to underlying impaired cardiovascular function. It is known that alarm sounds trigger a stress response.Firefighters respond to different alarms while on the job, each indicating different call types, such as a house fire or a medical emergency. Due to the prevalence of impaired cardiovascular health in firefighters, the physical stress resulting from these alerts is cause for concern.The blood pressure surge response to different call types and job activities in healthy and hypertensive firefighters had not been measured before this study.Through the ambulatory blood pressure monitoring of 111 on-duty firefighters, this study discovered that medical calls caused the greatest blood pressure and heart rate surge.Also, firefighters with hypertension experienced a greater blood pressure surge in response to alarms than their non-hypertensive co-workers.

Magnitude of hypertension and its association with obesity among employees of Wallaga University, Ethiopia: a cross-sectional study

OBJECTIVE

To determine the magnitude of hypertension, its association with obesity and the associated factors among employees of Wallaga University, Ethiopia.

DESIGN, SETTING AND PARTICIPANTS

This institution-based cross-sectional study was employed among 588 employees of the university. Respondents were selected by stratified random sampling technique and interviewed with the aid of a structured questionnaire.

THE MAIN OUTCOME MEASURED

Hypertension and obesity were measured using WHO Stepwise approach and recommendations. We used a stratified random sampling technique to select 588 employees of the university from 3 August 2021 to 15 October 2021. A structured questionnaire and anthropometric measurements were used for data collection. Multivariable logistic regression analysis was used to determine factors independently associated with hypertension. A p value less than or equal to 0.05 and its 95% confidence level was used to declare the statistical significance.

RESULTS

A total of 578 participants consented and completed the study, giving a response rate of 98.3%. The mean age of the respondents was 31.78 years with SD of 5.4. The overall prevalence of hypertension, general obesity and central obesity was 14.4% (95% CI 11.6% to 17.5%), 31.3% (95% CI 27.6% to 35.3%) and 37% (95% CI 33.1% to 41.1%), respectively. Obesity was significantly associated with hypertension (adjusted OR (AOR): 6.3; 95% CI 2.60 to 8.19). Age range from 35 to 46 (AOR 7.01; 95% CI 1.56 to 31.74), age ≥46 years (AOR 8.45; 95% CI 1.14 to 62.04), being non-academic staff (AOR 2.74; 95% CI 1.56 to 4.81), having additional income (AOR 2.48; 95% CI 1.08 to 5.70), physical inactivity (AOR 2.36; 95% CI 1.44 to 3.88) and poor practice of dietary salt consumption (AOR 1.65; 95% CI 1.01 to 2.87) were factors associated with hypertension.

CONCLUSION

One in seven, more than two in seven and nearly two in six of the employees of Wallaga University were hypertensive, centrally obese and generally obese, respectively. There was a positive association between obesity and hypertension. Comprehensive awareness creation and devising workplace intervention strategies are highly recommended to reduce the hypertension burden and associated obesity.

Stress as a possible cause of a high incidence of hypertension and diabetes and a low incidence of asthma in the Iraqi population

Hypertension and diabetes represent a significant public health burden worldwide and are significant risk factors for heart disease and stroke. Nevertheless, Iraqi people, in particular, experience higher levels of stress due to political instability and economic issues. The study aimed to investigate the prevalence of common morbidities among Iraqi patients and the possible relationship with exposure to stress. The data was collected from patients (n=500) who attended the health center in Najaf, Iraq, between 25 August 2021 and 30 September 2021. The prevalence of hypertension, diabetes, and asthma among Iraqi people was determined along with patients' awareness and control of these conditions. In addition, patients were asked about their experiences with stress, including the type of stress they encountered. Our findings revealed that nearly 47% of patients involved in this study had hypertension, with the highest percentage in patients over 40. Moreover, the incidence of diabetes was 12%, with the highest incidence in the age group of 40-59. The incidence of asthma was lower in all groups. Data analysis concerning exposure to stress demonstrated that about 60% of patients suffer from a stressful life. We found that the incidence of hypertension and diabetes was high while the incidence of asthma was low. This study also reveals that a considerable number of people were unaware of their hypertension and diabetes. Exposure to daily life stress among Iraqi people may play a role in the observed incidence of these morbidities.

A cohort study on the association between changing occupational stress, hair cortisol concentration, and hypertension

OBJECTIVE

To explore the relationship between changing occupational stress levels, hair cortisol concentration (HCC), and hypertension.

METHODS

Baseline blood pressure of 2520 workers was measured in 2015. The Occupational Stress Inventory-Revised Edition (OSI-R) was used to assess changes in occupational stress. Occupational stress and blood pressure were followed up annually from January 2016 to December 2017. The final cohort numbered 1784 workers. The mean age of the cohort was 37.77±7.53 years and the percentage male was 46.52%. At baseline, 423 eligible subjects were randomly selected for hair sample collection to determine cortisol levels.

RESULTS

Increased occupational stress was a risk factor for hypertension [risk ratio (RR) = 4.200, 95% confidence interval (CI): 1.734-10.172]. The HCC of workers with elevated occupational stress was higher than that of workers with constant occupational stress [(ORQ score ≥70: geometric mean±geometric standard deviation = 5.25±3.59 ng/g hair; 60-90: 5.02±4.00; 40-59: 3.45±3.41; <40: 2.73±3.40) x2 = 5.261]. High HCC increased the risk of hypertension (RR = 5.270, 95% CI: 2.375-11.692) and high HCC was associated with higher rates of elevated diastolic and systolic blood pressure. The mediating effect of HCC was 0.51[(95% CI: 0.23-0.79, odds ratio(OR) = 1.67] and accounted for 36.83% of the total effect.

CONCLUSIONS

Increased occupational stress could lead to an increase in hypertension incidence. High HCC could increase the risk of hypertension. HCC acts as a mediator between occupational stress and hypertension.

The Interaction between Occupational Stress and Smoking, Alcohol Drinking and BMI on Hypertension in Chinese Petrochemical Workers

BACKGROUND

Hypertension is one of the most vital risk factors for cardiovascular diseases, so we wanted to explore the impact of the interaction between occupational stress and smoking, alcohol drinking and BMI on hypertension in Chinese petrochemical workers.

METHODS

A total of 1488 employees participated. Questionnaires included the value of blood pressure, occupational stress (assessed by the effort-reward imbalance scale), demographic factors and work conditions. Multivariable logistic regression was used to explore related factors, and the interactions between occupational stress and smoking, alcohol drinking and BMI on hypertension were analyzed using an additive model.

RESULTS

The prevalence of hypertension was 34.3%. Age ≥ 56 (OR = 3.19, 95%CI: 1.841-5.526), male (OR = 1.436, 95%CI: 1.056-1.954), BMI ≥ 25 (OR = 1.86, 95%CI: 1.468-2.346), smoking (OR = 1.52, 95%CI: 1.191-1.951) and alcohol drinking (OR = 1.53, 95%CI: 1.180-1.972), ERI > 1 (OR = 1.50, 95%CI: 1.133-1.960) are risk factors for hypertension, and a higher education level (OR = 0.57, 95%CI: 0.438-0.754) is a protective factor against hypertension. Positive interactions existed between occupational stress and smoking (RERI = 2.134, AP = 0.328, S = 1.635), alcohol drinking (RERI = 2.332, AP = 0.361, S = 1.746) and BMI (RERI = 1.841, AP = 0.340, S = 1.717) on hypertension in petrochemical workers.

CONCLUSIONS

Age, gender, educational level, BMI, smoking, alcohol drinking and occupational stress are closely related to the risk of hypertension. There are also positive interactions between occupational stress and alcohol drinking, smoking and BMI, which have a certain impact on hypertension.

The relationship between occupational stress and job burnout among female manufacturing workers in Guangdong, China: a cross-sectional study

This study aims to investigate the relationship between occupational stress and job burnout in female manufacturing workers. A random sample of 1081 female workers in electronic manufacturing in Guangdong Province participated in the present study. An anonymous self-administered questionnaire that covered social-demographic characteristics, the Chinese version of the Job Content Questionnaire, the Chinese version of the Effort-reward Imbalance Questionnaire, and the Maslach Burnout Inventory for the General Survey, was used to assess occupational stress and job burnout. Independent sample t-test, one-way analysis of variance (ANOVA), correlation analysis, hierarchical multiple regression analysis and logistic regression analysis were used in data analysis. Occupational stress was positively correlated with emotional exhaustion and depersonalization and negatively correlated with personal accomplishment. After adjusting for sociodemographic characteristics, job strain was a risk factor for emotional exhaustion (OR = 2.27, 95% CI: 1.61-3.20) and depersonalization (OR = 1.96 95% CI: 1.45-2.64). Female workers with high effort-reward imbalance had an increased risk of depersonalization (OR = 1.96, 95% CI: 1.33-2.90). Furthermore, female workers with high overcommitment had an increased risk of emotional exhaustion (OR = 3.07, 95% CI: 2.06-4.58) and depersonalization (OR = 2.83, 95% CI: 1.92-4.17), while higher social support reduced the risk of emotional exhaustion (OR = 0.37, 95% CI: 0.26-0.53). The job burnout of female manufacturing workers is significantly correlated with their occupational stress. Higher job strain and overcommitment might be important contributors to job burnout. Increased worker social support can reduce job burnout.

Flare-Ups in Crohn's Disease: Influence of Stress and the External Locus of Control

(1) Background: The aim of this study was to explore the role of perceived stress and the health locus of control in Crohn's disease and their influence upon the development of flare-ups of this disease. (2) Methods: Stress and the external locus of control were evaluated in a sample of 64 Crohn's patients (flare-up phase versus latency phase). The perceived stress scale (PSS-14) and the multidimensional health locus of control scale were the measurement instruments used. (3) Results: The results indicate that the patients have high stress levels during a flare-up (26.13; 27.44; 28.79; 29.67); high stress levels (28.07; 29.67; 27.44; 28.07) if they have a high external locus of control; and that the external locus of control and stress levels have a significant influence upon the existence of flare-ups in those patients with low external locus of control levels (χ2 = 11.127; df = 1: p < 0.001). (4) Conclusions: Actions aimed at reducing stress and external locus of control levels are necessary in Crohn's disease.

A Descriptive Exploratory Study of the Causes and Effects of Hypertension Among Ghanaian Soldiers and Their Families

INTRODUCTION

The quality of life of any soldier can be affected by a simple diagnosis of Hypertension. Hypertension has not been directly linked to a single cause; however, knowing the associated risks and early diagnosis can help with its management. This study aimed to explore and describe the causes of hypertension among soldiers and its effects on their families.

OBJECTIVES

To explore and describe the causes of hypertension and its effects on soldiers and their families.

METHODS

A qualitative technique and an exploratory descriptive design were used in this study. At saturation, a total of 10 soldiers were face-to-face interviewed and gathered data simultaneously transcribed and subjected to a content analytic method of analysis. Participants approved being audio recorded on tape with an audio recording device.

RESULTS

Effects of hypertension on personal lives of soldiers, effects of hypertension on family life, and effects of hypertension on social life were identified as the causes and risk factors of hypertension among the soldiers. These themes are further expanded by their subthemes in the areas of decreased physical activity including sex life, decrease interaction with family, and isolation from friends.

CONCLUSION

This study revealed that hypertension does have effects on one's personal life, family life, and social life. Hence, it is recommended that frequent health education on hypertension and its effects should be organized in the various Garrisons by the public health department for all soldiers and their families. Screening programs should be organized for early hypertension detection. Soldiers should be educated on appropriate eating habits, weight and financial management, and reduction in tobacco and alcohol.

The prevalence of Schistosoma mansoni infection among adults with chronic non-communicable diseases in Malawi

BACKGROUND

Schistosomiasis is a parasitic infectious disease caused by flatworms of the Schistosoma genus. The global burden of schistosomiasis is high. In Malawi, schistosomiasis is among the top 20 causes of outpatient department visits in health facilities. Schistosomiasis is among the most important but neglected causes of non-communicable diseases (NCD) peculiar to tropical endemic settings. While much is known about the contribution of S. haematobium to the NCD burden in Malawi, the role of S. mansoni remains largely unknown.

METHODS

We conducted a cross-sectional study at Mangochi District Hospital. Adults over 18 years diagnosed with NCDs (n = 414), admitted or attending weekly outpatient clinics were recruited between August 2021 and February 2022. Data were collected on sociodemographic characteristics, medical history, body weight, blood pressure, and fasting blood glucose. Stool and midstream urine were collected for Kato-Katz (KK) microscopy and urine point of care-circulating cathodic antigen (POC-CCA) tests, respectively. We computed prevalence of S. mansoni as number of positive KK and CCA tests, each divided by total submitted samples. Univariate and multivariable logistic regression were done to evaluate risk factors of NCDs and association between S. mansoni infection and NCDs.

RESULTS

We recruited 414 participants, mean age 57 years (SD 16), 67% of whom were female. Prevalence of S. mansoni based on urine CCA was 15% (95% CI: 11-19) and 0% on KK microscopy. Hypertension was the most common condition with a prevalence of 85% (95% CI: 81-89), followed by diabetes mellitus with a prevalence of 42% (95% CI: 37-46) and heart disease with a prevalence of 3% (95% CI: 2-5). S. mansoni infection was not significantly associated with hypertension (OR: 1.2, 95% CI: 0.5-3.1), diabetes (OR: 0.6, 95% CI: 0.3-1.10) or heart disease (OR: 2.0, 95% CI: 0.4-10).

CONCLUSIONS

We observed moderate prevalence of S. mansoni infection among adults in the study per WHO classification of endemicity. This is within the range observed in children in Mangochi from 10 to 56.7%.

Stress-induced arterial hypertension

Stress is considered as one of the factors associated with the development of many diseases, including the cardiovascular system. The history of studying stress as a risk factor for hypertension began in the first half of the 20th century and continued after the introduction of 24-hour blood pressure monitoring (ABPM) into clinical practice. Then it turned out that there is normotension, stable hypertension and latent hypertension: masked (when clinical BP is within the normal range, and arterial hypertension is recorded according to ABPM and/or self-monitoring of BP) and white coat hypertension (increased BP during a visit to the doctor when normal values of blood pressure according to ABPM or self-monitoring of BP). Currently, both variants of latent hypertension are classified as stress-induced arterial hypertension. Several models have been proposed for the study of stress, but two of them are more common in clinical studies: the Karasek model (based on an imbalance between job demands and job decision latitude) and the Siegrist model (based on an imbalance of effort and reward). There are only few studies in where attempts have been made to link the increase in BP with the parameters of stress response (for example, with hormonal levels) or genetic predisposition. The review discusses the most significant studies of stress-induced arterial hypertension published to date.

Blood Pressure Responses in Firefighters: A Review

Blood pressure (BP) responses are controlled by various factors and understanding how BP changes is important to occupational health. This paper presents a review of the literature that reports BP responses in the firefighter population. Hypertension is one of the main risk factors underlying the pathophysiology of cardiovascular disease (CVD), and cardiac incidents remain the leading cause of line-of-duty deaths in firefighters. Risk factors for line-of-duty deaths include obesity, previous or underlying heart disease, and hypertension. The occupation of firefighting is one of the most hazardous and dangerous jobs, yet over 50 % of firefighters are volunteers. Tactical operations and the hazardous nature of firefighting are exposures that influence stress responses and, therefore, affect BP. In fact, hypertension in firefighters often remains undocumented or undiagnosed. CVD risk and elevated BP in tactical populations, like firefighters, maybe a combination of physical and emotional stress due to the nature of the job. Cross-sectional studies have reported that firefighters have higher levels of BP and higher rates of hypertension compared to civilians. Interestingly, there is a limited amount of research that reports BP values before and after firefighting- related activities, and very few studies on interventional changes in BP. Here, we synthesize the literature on firefighting and provide a summary of the studies that report pre- and post- BP levels that relate to CVD risk factors, occupational factors, firefighting activities, and the data on exercise training and BP. More studies are needed that examine BP in firefighters and report on the changes in BP with occupational activities.

Effects of a Yoga-Based Stress Intervention Program on the Blood Pressure of Young Police Officers: A Randomized Controlled Trial

Objectives: Despite improvements in health education and treatment, arterial hypertension remains a major health problem of increasing epidemiological importance. The purpose of this randomized controlled trial was to determine the impact of regular yoga breathing exercises on blood pressure, work-related stress, and the prevalence of arterial hypertension in young police academy trainees with no existing comorbidities. Design: A single-center, prospective, randomized controlled trial. Subjects: The study included 120 healthy trainees aged between 18 and 39 years who practiced weekly yoga exercises with an emphasis on breathing (prāṇāyāma) over an observation period of 6 months. Results: These regular exercises lowered the blood pressure of the participants by 1.34 mmHg (right arm, p = 0.007), increased their regenerative capacity (Recovery Experience Questionnaire [REQ] scale +2.77, p < 0.001) and resilience (Resilience Scale [RS] +4.6, p = 0.001), and concomitantly reduced the level of perceived stress (Perceived Stress Scale [PSS] -0.9, p < 0.001). In contrast, blood pressure in the control group had slightly increased over the study period by 0.1 mmHg (right arm, p < 0.001) and 1.0 mmHg (left arm, p = 0.03), and subjective scores had significantly worsened (REQ scale -3.4, p < 0.001; RS -2.29, p = 0.001; PSS +0.88, p < 0.001). Conclusions: The results point to a significant correlation between blood pressure and both regenerative capacity and stress level. Thus, the study confirms the hypothesis that yoga exercises reduce perceived stress and exert positive effects on blood pressure. Clinical Trial Registration Number: DRKS00025921.

Workplace stress and discrimination effects on the physical and depressive symptoms of underrepresented minority faculty

Evidence-based research and interventions to address systemic institutional racism have never been more urgent. Yet, underrepresented minority (URM) professionals in research institutions who primarily produce that evidence have remained abysmally low for decades. This unique study of URM university professors assesses factors-vocational strain, role overload, discrimination, coping strategies-that contribute to health and well-being, research productivity, and ultimately their retention in high impact research positions. We administered a web-based survey assessing demographics, workplace stressors, perceived discrimination, life events, coping strategies, and physical and depressive symptoms. Study participants include 404 faculty of whom 254 are African Americans, 99 are Mexican Americans, and 51 are Puerto Ricans. Hierarchical regression analyses were employed to assess the associations between workplace stress, coping strategies, and symptoms. Results show that perceived discrimination, vocational strain, role overload, and life events directly affected physical symptoms, with self-care (p < 0.001) moderating these effects. Vocational strain and life events had direct effects on depressive symptoms with self-care (p < 0.05) and social support (p < 0.001) moderating these effects. Findings inform health care providers and university leaders about work stress and health conditions that may explain early morbidity and premature departures of URM faculty, and proffer institutional interventions to retain these faculty.

The association between job stress and metabolic syndrome among medical university staff

Background

The relationship between job stress and each component of metabolic syndrome has been previously suggested; however, this association is not consistent. The present study was conducted to assess the association between job stress and metabolic syndrome and its components in a group of Iranian workers affiliated with Tehran University of Medical Sciences.

Methodology

This cross-sectional study was performed on 3,537 randomly selected staff in Tehran University of Medical Sciences including the staff of clinical, administrative, and service departments with at least one year of working experience. The overall frequency of metabolic syndrome was assessed based on the international diabetes federation (IDF) criteria. The Persian version of the Copenhagen Psychosocial Questionnaire (COPSOQ) was used to measure major domains of psychosocial factors in the workplace.

Results

The overall frequency of metabolic syndrome in the assessed personnel was estimated to be 22.1 % and there was a significantly higher rate of metabolic syndrome in office workers and service personnel compared to clinical staff (OR: 1.51, CI 95 %: 1.25-1.82 and OR: 1.74, CI 95 %: 1.41-2.14, respectively). Health and well-being as a major domain of COPSOQ was found to be significantly impaired by the presence of metabolic syndrome. According to the results of multiple logistic regression modeling, the relationship between metabolic syndrome and impaired health and well-being domain remained significant after adjusting for age, gender, marital status, educational level, and employment category.

Conclusions

Our findings revealed a close association between job-related stress and the impaired well-being in the presence of metabolic syndrome among the medical university staff.

The Impact of Caring and Killing on Physiological and Psychometric Measures of Stress in Animal Shelter Employees: A Pilot Study

Animal shelter employees are in a unique position where they care for, and later kill, the same animals. The aim of our exploratory study was to assess whether "caring" and/or "killing" evokes physiological and psychometric indicators of stress in employees. Experiment 1 compared three careers that kill regularly, but involve varying degrees of husbandry (n = 28). Blood pressure (BP), salivary cortisol, heart rate (HR), and heart rate variability (HRV) were collected; data showed higher HR and lower HRV during the process of killing. Psychometric scales showed that burnout and Impact Event Scale-Revised (IES-R) scores were higher in careers with higher contact with animals. Experiment 2 compared three careers that involve husbandry, but varying exposure to killing (n = 41). BP, cortisol awakening response, HR, and HRV were measured as well as Professional Quality of Life Scale, IES-R, and Moral Injury Event Scale were administered. There were no significant differences across careers in any measures. The data suggest that the process of killing may be physiologically stressful to the person, and higher levels of animal contact in a euthanasia context may be associated with burnout and traumatic stress, but that the act of euthanasia is not a unique predictor of overall occupational distress.

The Provision of Clergy Health Resources by Faith-Based Organizations in the USA

The purpose of this study was to describe practices and perceptions related to promoting clergy health among a national sample of denomination-level faith-based organizations (FBOs) (N = 154). Stress was identified as the top health-related issue facing clergy. The most commonly offered health resource was employer-sponsored health insurance. Lack of financial resources was the most common barrier to providing health resources for clergy. This study highlights potential priorities for denomination-level FBOs interested in providing health resources for clergy.

Hypertension among Mississippi Workers by Sociodemographic Characteristics and Occupation, Behavioral Risk Factor Surveillance System

In 2017, Mississippi had the third highest age-adjusted prevalence of hypertension in the United States. We estimated the prevalence of hypertension by sociodemographic characteristics and occupation and examined the association between hypertension with occupation and sociodemographic characteristics among Mississippi workers. We calculated adjusted prevalence and adjusted prevalence ratios (APRs) by sociodemographic characteristics and occupation among Mississippi adult workers. We analyzed combined 2013, 2015, and 2017 data from the Mississippi Behavioral Risk Factor Surveillance System for 6,965 workers in ten Standard Occupational Classification System major groups. Of the estimated 1.1 million Mississippi workers during the three survey years, 31.4% (95% confidence interval (CI), 30.0–32.8) had hypertension. The likelihood of having hypertension was significantly higher among workers aged 30–44 years, 45–64 years, blacks, and those classified as overweight and obese workers compared to their counterparts. The likelihood of having hypertension among workers in the fields of installation, repair and maintenance, and production were 26% higher (APR, 1.26; 95% CI, 1.03–1.55) and 33% higher (APR, 1.33; 95% CI, 1.11–1.58), respectively, than workers in all other occupational groups. Among Mississippi workers, hypertension prevalence varied by sociodemographic characteristics and occupational groups. Age, race, obesity status, installation, repair, maintenance, and production occupation groups are associated with an increased likelihood of hypertension. Novel and/or community-based or linked programs are needed that could target workers at risk of hypertension that are outside of a single-site workplace.

Occupational and environmental influences on hypertension

In this review I try to summarize concisely available information on common effectors on blood pressure, occupational, and environmental ones, which are sometimes overlooked, so that clinicians involved in caring for patients with hypertension may have somewhat better vision of what our patients are exposed to.

HbA1c AND BLOOD PRESSURE MEASUREMENTS: RELATION WITH GENDER, BODY MASS INDEX, STUDY FIELD, AND LIFESTYLE IN LEBANESE STUDENTS

Objective: The purpose of this study is to determine the prevalence of prediabetes/diabetes in Lebanese university students and to examine the relationship between both hemoglobin A1c (HbA1c) and blood pressure (BP) and gender, body mass index (BMI), study field, and lifestyle factors. Methods: This cross-sectional study was carried out at the Saint-Joseph University of Beirut. A total of 603 students aged 18 to 25 years were recruited from both the medical science campus (MSC) and the social science campus (SSC) between January, 2016, and May, 2018. Waist circumference (WC), BMI, and BP were determined for each student and HbA1c was measured using the Siemens vintage DCA device. Participants completed a self-administered questionnaire about their eating habits and level of physical activity. Results: The mean age of the population was 20.31 ± 1.76 years. The percentage of participants recruited from the MSC was 59.2%. The prevalence of prediabetes was 2.5%. Lower BMI, WC, and HbA1c values, and higher diastolic BP (DBP) were found in MSC students compared to SSC ones. HbA1c, systolic BP (SBP), and DBP were correlated with BMI (P = .02, P<.0001, and P = .017, respectively). HbA1c was not associated with eating habits or physical activity. DBP was inversely associated with physical activity (P = .002), while SBP was positively associated with fast food consumption (P = .003). Conclusion: The present study shows a low prevalence of prediabetes in Lebanese students. BMI and the study field are the main factors predicting HbA1c and BP. Further studies are needed to extrapolate our results to the overall young Lebanese population. Abbreviations: ADA = American Diabetes Association; BMI = body mass index; BP = blood pressure; DBP = diastolic blood pressure; HbA1c = hemoglobin A1c; HTN = hypertension; MSC = medical science campus; SBP = systolic blood pressure; SSC = social science campus; T2D = type 2 diabetes; US = United States; USJ = Saint-Joseph University; WC = waist circumference.

Antecedents of women managers’ resilience: conceptual discussion and implications for HRM

Purpose

This paper aims to provide a framework with the antecedents of women managers’ resilience in SMEs.

Design/methodology/approach

This developmental study uses a comprehensive literature review and a set of propositions to identify the antecedent of women managers’ resilience and develops a conceptual framework for resilience.

Findings

The results indicate that in addition to personal resilience traits, interactive engagement with the work environment, career adaptability and positive human resource management (HRM) interventions are the main antecedents of women managers’ resilience.

Research limitations/implications

This paper contributes to theory by providing a new perspective on the study of resilience as a process at the organisational level and as a trait at personal level. It contributes to the women employee-centric resilience discussion in HRM literature and explores the relationship between resilience and women managers’ career progression. This is a developmental study, and despite the strengths of the undertaken approach, there are a number of limitations due to the lack of empirical evidence. Therefore, future research activities should focus on validating the framework and determining any potential boundaries of this resilience framework.

Practical implications

The study reveals a number of practical implications leading to a recommended resilience toolkit for HR managers of organisations to develop and promote resilience in their women managers and aspiring managers.

Social implications

The social implications of this study include the social relationships within the work-setting, better employee engagement and interaction with the work environment and flexible career progression pathways.

Originality/value

The paper is based on rich conceptual and theoretical discussion that identifies the key antecedents of women managers’ resilience. The study also conceptually establishes the moderating relationship between women managers’ resilience and work stress and burnout.

An Examination of the Relationship between Discrimination, Depression, and Hypertension in Native Hawaiians

Native Hawaiians bear a disproportionate burden of hypertension. Discrimination and depression are potential hypertension risk factors. Although the relationship between discrimination and depression is well established, how these factors affect hypertension risk in indigenous populations remains unknown. We examined the relationship between discrimination, depression, and hypertension in adult Native Hawaiians. We hypothesized that greater frequency of perceived discrimination and greater frequency of depressive symptoms would independently increase the likelihood of having hypertension. Surveys were mailed to 540 adult Native Hawaiians residing on five Hawaiian Homesteads. The surveys measured: hypertension status, sociodemographic factors (age, gender, income, employment status), body mass index (BMI), physical activity frequency, smoking, Hawaiian cultural affiliation, American cultural affiliation, perceived discrimination, and depressive symptoms. Respondents (n=171) were mostly female (71%), a mean age of 57yrs, and 54% reported having hypertension. The logistic regression model included perceived discrimination, depression, BMI, frequency of vigorous physical activity, and Hawaiian cultural affiliation, and sociodemographic variables. The model showed that Hawaiian cultural affiliation and discrimination were significantly related to hypertension status. Depression was not related to hypertension status. Interaction analysis found that for individuals with lower Hawaiian cultural affiliation, frequent perceived discrimination was significantly associated with lower odds of having hypertension. The negative association between perceived discrimination and hypertension status was opposite from hypothesized. However, the interaction suggests this relationship holds only for less culturally affiliated individuals. These results underscore the varied nature of hypertension determinants and may have clinical implications for the treatment of hypertension in Native Hawaiians.

Job strain associated with increases in ambulatory blood and pulse pressure during and after work hours among female hotel room cleaners

BACKGROUND

Previously documented elevated hypertension rates among Las Vegas hotel room cleaners are hypothesized to be associated with job strain.

METHODS

Job strain was assessed by questionnaire. Ambulatory blood pressure (ABP) was recorded among 419 female cleaners from five hotels during 18 waking hours. Multiple linear regression models assessed associations of job strain with ABP and pulse pressure for 18-h, work hours, and after work hours.

RESULTS

Higher job strain was associated with increased 18-h systolic ABP, after work hours systolic ABP, and ambulatory pulse pressure. Dependents at home but not social support at work attenuated effects. Among hypertensive workers, job strain effects were partially buffered by anti-hypertensive medication.

CONCLUSIONS

High job strain is positively associated with blood pressure among female hotel workers suggesting potential for primary prevention at work. Work organizational changes, stress management, and active ABP surveillance and hypertension management should be considered for integrated intervention programs.

Physiological reactions to long-term fishing in the Barents Sea

Background

Fishing in distant waters for months may induce physiological stress.

Aims

To assess the physiological stress reactions in fishermen working for 2-3 months continuously in 6-h shifts on trawlers in the Barents Sea.

Methods

The crew of five trawlers fishing in the Barents Sea from January to April 2004 were invited to participate. In the week before and 5-7 days after the trip, the following measures were collected: salivary cortisol four times a day, 24-h urinary cortisol, blood pressure, heart rate, serum cholesterol, serum high-density lipoprotein (HDL-cholesterol), HbA1c (glycosylated haemoglobin) and weight. In addition, 24-h urinary cortisol, blood pressure and heart rate were measured three times. A questionnaire on health, social conditions and work environment was obtained after the trip.

Results

In total, 136 men agreed to participate. Full data were obtained for 96 fishermen (70%). A significant decrease in salivary and urinary cortisol was found during the trip. Adjustment for age, body mass index, smoking, shift work schedule and time of day for sample collection did not change this finding. Systolic and diastolic blood pressure declined significantly and remained significantly lower after the trip compared to before the trip. Serum cholesterol/HDL ratio declined significantly, whereas triglycerides, HbA1c and weight were unchanged.

Conclusions

Working up to 3 months on 6-h shifts, 84 h a week, with moderate physical activity, even in artificial light and cold weather on a ship, did not result in increased physiological stress.

Work-family spillover and metabolic syndrome indicators: Findings from a national sample

This study examines the link between negative work-family spillover and metabolic risk factors over a 9-year period. Data from two waves of the Midlife in the United States Survey were used to explore relationships between negative work-family spillover and four indicators of metabolic syndrome-blood pressure, triglycerides, body mass index, and glucose levels. In a sample of full-time working men and women (N = 630), increased negative spillover at baseline significantly predicted higher body mass index nearly a decade later, with a marginally significant effect for triglyceride levels. Increases in spillover also body mass index and glucose levels at follow-up. This study extends research tying work-life spillover to health and suggests that further investigation is needed to fully understand the long-term effects of work stress.

Prevalence, awareness, treatment, and control of hypertension among Chinese working population: results of a workplace-based study

We investigated the prevalence, awareness, treatment, and control of hypertension and the related risk factors among Chinese working population. From 2012 to 2013, a total of 37,856 employees aged 18-60 years from 61 workplaces were sampled. Standard questionnaire surveys and physical examinations were undertaken. Multilevel logistic regression models were performed to identify the risk factors. Overall, the age-standardized prevalence of hypertension was 23.3% (95% confidence interval [CI]: 22.9%-23.7%). Among the hypertensives, 47.8% (95% CI: 46.8%-48.8%) were aware of their condition, 20.6% (95% CI: 19.8%-21.4%) were in treatment, but only 8.5% (95% CI: 7.9%-9.1%) had controlled hypertension. White-collar employees had a lower odds of hypertension compared with the blue-collar (odds ratio: 0.77, 95% CI: 0.71-0.84), whereas the state-owned enterprise employees had a higher odds compared with their private enterprise counterparts (odds ratio: 1.69, 95% CI: 1.07-2.65). Lower awareness and treatment were associated with being younger, higher education, and those from workplace without affiliated hospital. Higher occupation status individuals were more likely to be treated but no sign of better control. There is substantial room for improvement in hypertension diagnosis and treatment among the employees. Effective intervention programs are urgently needed at the workplaces.

Occupational Stress and Hypertension among Railway Loco Pilots and Section Controllers

Introduction:

A cross-sectional study on occupational stress was conducted on loco pilots in 2008, in view of loco pilots being one of the high strain jobs in Indian Railways. Subsequently, a comparative cross-sectional study on occupational stress was conducted among section controllers in 2011, which is another high strain job of Indian Railways.

Objective:

The studies were conducted to analyze and compare occupational stress and hypertension.

Setting and Design:

A cross-sectional study on occupational stress and hypertension was conducted among 230 loco pilots in 2008, and subsequently, a comparative cross-sectional study was conducted among 82 section controllers in 2011.

Materials and Methods:

A closed end 24 item questionnaire on occupational stress was administered. Systolic blood pressure above 140 mmHg and diastolic blood pressure above 90 mmHg were considered as hypertension as per the VII Joint National Committee. Chi-square test and t-test were used for testing significance at P < 0.05.

Results:

The mean stress score was 8.56 in loco pilots and 7.32 in section controllers. The number of loco pilots with more than 12 stress factors was 49 (21.3%) and the number of section controllers with more than 12 stress factors was 7 (8.5%). The number employees with more than 12 stress factors in different categories of loco pilots were 30 (32%) in the goods category, 12 (12%) in the mail/passenger category, and 7 (19%) in the shunter category, and 3 (11%) in the supervisory category and 4 (7%) in the on-board category of section controllers. The prevalence of hypertension in loco pilots was 36.52% (84) and in the section controllers was 53.66% (44). The prevalence of hypertension in the category with more than 12 stress factors was 30.61% (15) in the loco pilots and 28.57% (2) in the section controllers. The prevalence of hypertension in the both the study groups were higher in the older age, with a family history of hypertension, and with a body mass index of more than 25 kg/m². The mean occupational stress and employees with more than 12 stress factors were higher in the loco pilots group. The goods category of loco pilots had highest stress factors. The prevalence of hypertension was high in the category with risk factors such as older age, family history of hypertension and BMI above 25 kg/m².

Opportunities for the Advanced Practice Nurse to Enhance Hypertension Knowledge and Self-management Among African American Women

PURPOSE

Despite increased awareness and the advent of methods to manage the disease, hypertension is poorly controlled among African American women. This study explored hypertension knowledge and blood pressure in a sample of African American women.

DESIGN

A descriptive, cross-sectional design was used to collect survey data on hypertension knowledge.

METHODS

African American women attending a church conference were invited to complete a questionnaire, which included the Check Your High Blood Pressure Prevention IQ survey, and had their blood pressures measured.

RESULTS

Of the 151 women who participated, 62% were diagnosed with hypertension. Many of the women, even those not diagnosed with hypertension, had elevated blood pressures. Although the average scores showed that the women scored well on the survey, there were 4 items on the survey that a percentage of the women had difficulty with: questions about (1) stress as a cause of hypertension, (2) symptoms associated with high blood pressure, (3) whether hypertension could be cured, and (4) the amount of exercise needed to help reduce blood pressure.

CONCLUSION

Despite efforts to increase awareness and control of hypertension, considerable misconceptions about the disease were found in this sample of African American women. To improve self-management of hypertension among this group, advanced practice nurses need to directly address these misconceptions.

Comparison of Machine Learning Methods for the Arterial Hypertension Diagnostics

The paper presents results of machine learning approach accuracy applied analysis of cardiac activity. The study evaluates the diagnostics possibilities of the arterial hypertension by means of the short-term heart rate variability signals. Two groups were studied: 30 relatively healthy volunteers and 40 patients suffering from the arterial hypertension of II-III degree. The following machine learning approaches were studied: linear and quadratic discriminant analysis, k-nearest neighbors, support vector machine with radial basis, decision trees, and naive Bayes classifier. Moreover, in the study, different methods of feature extraction are analyzed: statistical, spectral, wavelet, and multifractal. All in all, 53 features were investigated. Investigation results show that discriminant analysis achieves the highest classification accuracy. The suggested approach of noncorrelated feature set search achieved higher results than data set based on the principal components.

Ministry-Related Burnout and Stress Coping Mechanisms Among Assemblies of God-Ordained Clergy in Minnesota

Clergy members suffering from burnout face both personal and professional complications. This study assessed occupational burnout and stress coping mechanisms among ministers affiliated with the Assemblies of God, a denomination that has received little attention in previous burnout-related studies. A cross-sectional design was employed using two instruments with acceptable psychometric properties. Approximately 65 % of those surveyed were either suffering from burnout or on the verge of burnout. Statistical differences in coping mechanism use were found between those who were and were not experiencing some level of burnout. The results of this study add to the existing understanding of occupational burnout among clergy members and ways in which burnout may be alleviated.

Psychosocial Factors and Hypertension: A Review of the Literature

Black people have the highest prevalence of hypertension in the United States. Evidence suggests that psychosocial factors increase the risks for hypertension and help to account for racial differences in this condition. This article reviews research on psychosocial factors and hypertension, and contextualizes the findings within a health disparities framework. A wide range of psychosocial factors contribute to hypertension but understanding remains limited about how these factors relate to each other and accumulate to contribute to hypertension disparities. Future research on psychosocial factors and hypertension needs to enhance the effectiveness of interventions to reduce hypertension risk in ethnic minority communities.

The Vietnamese version of the Perceived Stress Scale (PSS-10): Translation equivalence and psychometric properties among older women

BACKGROUND

The Perceived Stress Scale 10 item (PSS-10) has been translated into more than 20 languages and used widely in different populations. Yet, to date, no study has tested psychometric properties of the instrument among older women and there is no Vietnamese version of the instrument.

METHODS

This study translated the PSS-10 into Vietnamese and assessed Vietnamese version of the Perceived Stress Scale 10 items (V-PSS-10) for translation equivalence, face validity, construct validity, correlations, internal consistency reliability, and test-retest reliability among 473 women aged 60 and over.

RESULTS

The study found that V-PSS-10 retained the original meaning and was understood by Vietnamese older women. An exploratory factor analysis of the V-PSS-10 yielded a two-factor structure, and these two factors were significantly correlated (0.56, p < .01) with all item loadings exceeded .50. The V-PSS-10 score was positively correlated with general sleep disturbance (ρ = .12, p < .05), CES-D score for depression symptoms (ρ = .60, p < .01), and negatively correlated with mental (ρ = -.46, p < .01), and physical health scores (ρ = -.19, p < .01). The Cronbach's alpha for the V-PSS-10 was .80, and the test-retest correlation at one month's interval was .43.

CONCLUSION

Findings from this study suggest that the V-PSS-10 has acceptable validity and reliability levels among older women. The V-PSS-10 can be used to measure perceived stress in future research and practice. However, future research would be useful to further endorse the validity and reliability of the V-PSS-10.

The relationship between: occupational status, biological condition and androgen hormone level among Polish adult men: the Wroclaw Male Study

Population health and its determinants are one of the major challenges to social and economic policy. The aim of this study was to investigate the relationship between occupational activity and biological condition in adult working Polish men. The participants of the study were 300 men (30-65 years), healthy inhabitants of the city of Wroclaw, Poland. Seventeen measures of biological condition were examined. The subjects were divided into three different occupational groups: professionals, soldiers and skilled workers. A comparison of biological age profiles of three occupational groups showed that in the majority of characteristics, professionals had the youngest biological age, whereas skilled workers had the highest biological age. The results for soldiers were not as unambiguous, but biological parameters were generally closer to those for professionals. Inborn biological predispositions and long-term impact of the working environment can influence on the biological condition of various professional groups. Knowledge of the determinants of biological condition might result in efficient use of predisposition to work or may be of help in extending their time of work ability.

Determinants, Health Problems, and Food Insecurity in Urban Areas of the Largest City in Cape Verde

Urbanization processes are intertwined with nutritional transition because there is easier access to food of low nutritional quality at reduced prices, changing dietary patterns and leading to an increase of non-communicable chronic diseases. This study aims to understand the perceptions for high blood pressure, obesity, and alcoholism, describing some interactions of these dimensions in the problem of food security in the city of Praia. A qualitative study was carried out under the framework of the research project "UPHI-STAT: Urban Planning and Health Inequalities-moving from macro to micro statistics". Ten focus groups were conducted in three urban areas with distinct characteristics in the city of Praia, with a total of 48 participants. Participants reported frequent consumption of foods with poor nutritional quality, understanding the potential danger in terms of food security in the city of Praia. Easy access to and high levels of alcohol consumption, and poor quality of traditional drinks were mentioned by participants in the study areas. The impact of the economic situation on the possibility of access to safe and healthy options emerged as a differentiating factor.

Relative hypocortisolism is associated with obesity and the metabolic syndrome in recurrent affective disorders

BACKGROUND

Cardiovascular disease (CVD) is one of the main causes of excess deaths in affective disorders. Affective disorders are associated with increased frequencies of CVD risk-factors such as obesity, dyslipidemia, and metabolic syndrome. Stress-induced chronic cortisol excess has been suggested to promote obesity and metabolic syndrome. Chronic stress with frequent or persisting hypothalamic-pituitary-adrenal-axis (HPA-axis) hyperactivity may, over time, lead to a state of low HPA-axis activity, also denoted hypocortisolism. A low-dose weight-adjusted dexamethasone-suppression-test (DST) is considered to be a sensitive measure of hypocortisolism.

METHODS

245 patients with recurrent depression or bipolar disorder and 258 controls participated in a low-dose DST and were also examined with regard to metabolic status.

RESULTS

Patients with hypocortisolism (low post-DST cortisol) compared with patients without hypocortisolism (normal or high post-DST cortisol) exhibited increased odds ratios (OR) for obesity (OR=4.0), overweight (OR=4.0), large waist (OR=2.7), high LDL (OR=4.2), low HDL (OR=2.4), high LDL/HDL ratio (OR=3.3), high TC/HDL ratio (OR=3.4) and metabolic syndrome (OR=2.0). A similar pattern but less pronounced was also found in the control sample.

LIMITATIONS

The cross sectional study design and absence of analyses addressing lifestyle factors.

CONCLUSIONS

Our findings suggest that a substantial portion of the metabolic disorders and cardiovascular risk factors seen in recurrent affective disorders are found among individuals exhibiting hypocortisolism. This might indicate that long-term stress is a central contributor to metabolic abnormalities and CVD mortality in recurrent affective disorders.

Anxiety, Stress-Related Factors, and Blood Pressure in Young Adults

Hypertension (HT) is a long-term medical condition characterized by persistently elevated blood pressure (BP) in the arterial vessels. Although HT initially is an asymptomatic condition, it chronically evolves into a major risk factor for cardiovascular, cerebrovascular, and renal diseases that, in turn, represent crucial causes of morbidity and mortality in industrialized countries. HT is a complex disorder that is estimated to affect more than a quarter of the world's adult population. It is classified on the basis of both its pathophysiology (primary and secondary HT) and on the resting BP values (elevated systolic, diastolic, and pulse pressure). It originates from a complicated interaction of genes and several environmental risk factors including aging, smoking, lack of exercise, overweight and obesity, elevated salt intake, stress, depression, and anxiety. Anxiety and depressive disorders are the most commonly diagnosed mental disorders, affecting millions of people each year and impairing every aspect of everyday life, both of them characterized by affective, cognitive, psychomotor, and neurovegetative symptoms. Moreover, work-related stress has been considered as an important risk factor for HT and cardiovascular diseases (CVDs). Although different authors have investigated and suggested possible relations between HT, stress, anxiety, and depression during the last decades, a full understanding of the underlying pathophysiological mechanisms has not been satisfactorily achieved, especially in young adults. The aim of this study was to investigate the impact of anxiety and work-related stress in the development of HT amongst young health care profession students and the possible related consequences of early CVDs.

Stress and Fatigue Management Using Balneotherapy in a Short-Time Randomized Controlled Trial

Objective. To investigate the influence of high-salinity geothermal mineral water on stress and fatigue. Method. 180 seamen were randomized into three groups: geothermal (65), music (50), and control (65). The geothermal group was administered 108 g/L salinity geothermal water bath for 2 weeks five times a week. Primary outcome was effect on stress and fatigue. Secondary outcomes were the effect on cognitive function, mood, and pain. Results. The improvements after balneotherapy were a reduction in the number and intensity of stress-related symptoms, a reduction in pain and general, physical, and mental fatigue, and an improvement in stress-related symptoms management, mood, activation, motivation, and cognitive functions with effect size from 0.8 to 2.3. In the music therapy group, there were significant positive changes in the number of stress symptoms, intensity, mood, pain, and activity with the effect size of 0.4 to 1.1. The researchers did not observe any significant positive changes in the control group. The comparison between the groups showed that balneotherapy was superior to music therapy and no treatment group. Conclusions. Balneotherapy is beneficial for stress and fatigue reduction in comparison with music or no therapy group. Geothermal water baths have a potential as an efficient approach to diminish stress caused by working or living conditions.

Perceived stress, sex and occupational status interact to increase the risk of future high blood pressure: the IPC cohort study

BACKGROUND

Contrary to lay beliefs, current perceived stress is not consistently associated with the incidence of high blood pressure (BP) in prospective studies, possibly because of moderating factors. The present prospective study examined this association and explored the potential moderating effects of sex or occupational status.

METHOD

The 4-item Perceived Stress Scale was filled at baseline by 19 766 normotensive adults (13 652 men, mean age ± SD: 46.8 ± 9.3 years), without history of cardiovascular and renal disease, and not on either psychotropic or antihypertensive drugs.

RESULTS

After a mean follow-up of 5.8 ± 2.1 years, 3774 participants (19.1%) had high BP, defined as having a SBP at least 140 mmHg or a DBP at least 90 mmHg, or using antihypertensive drugs. There was a significant interaction between baseline-perceived stress and sex (P = 0.02) in relation to high BP at follow-up. After adjustment for potential confounders, baseline perceived stress was associated with high BP at follow-up in women [odds ratio 1.20, 95% confidence interval 1.03-1.38, P = 0.016). In addition, the interaction between perceived stress and occupational status was significant among women (P = 0.02). Baseline-perceived stress was positively associated with high BP at follow-up among women of medium or low occupational status, with odds ratio suggesting a linear increase of the risk (P = 0.005).

CONCLUSION

Perceived stress may be considered as a risk factor for hypertension in women of lower occupational status. Research addressing the relationships between stress and high BP should systematically look for possible interactions with sex and occupational status.

Job Burnout, Work Engagement and Self-reported Treatment for Health Conditions in South Africa

The purpose of the study being reported here was to investigate the relationship of job burnout and work engagement with self-reported received treatment for health conditions (cardiovascular condition, high cholesterol, depression, diabetes, hypertension and irritable bowel syndrome), while controlling for age, gender, smoking and alcohol use. The sample comprised 7895 employees from a broad range of economic sectors in the South African working population. A cross-sectional survey design was used for the study. Structural equation modelling methods were implemented with a weighted least squares approach. The results showed that job burnout had a positive relationship with self-reported received treatment for depression, diabetes, hypertension and irritable bowel syndrome. Work engagement did not have any significant negative or positive relationships with the treatment for these health conditions. The results of this study make stakeholders aware of the relationship between job burnout, work engagement and self-reported treatment for health conditions. Evidence for increased reporting of treatment for ill-health conditions due to burnout was found. Therefore, attempts should be made to manage job burnout to prevent ill-health outcomes.