Job strain and ambulatory blood pressure: a meta-analysis and systematic review

Abstract

We reviewed evidence of the relationship between job strain and ambulatory blood pressure (ABP) in 29 studies (1985-2012). We conducted a quantitative meta-analysis on 22 cross-sectional studies of a single exposure to job strain. We systematically reviewed 1 case-control study, 3 studies of cumulative exposure to job strain, and 3 longitudinal studies. Single exposure to job strain in cross-sectional studies was associated with higher work systolic and diastolic ABP. Associations were stronger in men than women and in studies of broad-based populations than those with limited occupational variance. Biases toward the null were common, suggesting that our summary results underestimated the true association. Job strain is a risk factor for blood pressure elevation. Workplace surveillance programs are needed to assess the prevalence of job strain and high ABP and to facilitate workplace cardiovascular risk reduction interventions.

Figures

FIGURE 1—

Flowchart of included and excluded studies of job strain and ambulatory blood pressure. Note. CSA = Cambridge Scientific Abstracts.

FIGURE 2—

Forest plot of job strain and work systolic ambulatory blood pressure (mm Hg). Note. CI = confidence interval.