Advertisement

Effort–reward imbalance at work and 5-year changes in blood pressure: the mediating effect of changes in body mass index among 1400 white-collar workers

  • Xavier TrudelEmail author
  • Chantal Brisson
  • Alain Milot
  • Benoit Masse
  • Michel Vézina
Original Article

Abstract

Purpose

A number of prospective studies have documented the effect of adverse psychosocial work factors (work stress) on high blood pressure (BP). Weight gain could be an important pathway by which work stress exerts its effect on BP. No previous prospective study has examined this mediating effect. The aim of the present study was to examine the mediating effect of body mass index (BMI) in the association between psychosocial work factors from Siegrist’s effort–reward imbalance model (ERI) and ambulatory BP (ABP).

Methods

A prospective study was conducted among 1436 white-collar workers. Data were collected three times during a 5-year period. ERI was measured using validated scales, at each time. BMI was measured by a trained assistant. ABP was measured every 15 min during a working day.

Results

ERI exposure onset over 3 years was indirectly associated with ABP changes (0.49 mmHg; 95 % CI 0.05, 1.22), through BMI changes, in women with baseline BMI ≥25 kg/m2. An effect of similar magnitude and of borderline significance was observed for ERI chronic exposure. No mediating effect was observed among men, and using ERI exposure over 5 years.

Conclusion

The mediating effect of BMI was of small magnitude and observed in certain subgroups and time frame only. Subgroup-specific mediating pathways might be involved to explain the effect of work stress on cardiovascular diseases risk.

Keywords

Work stress Body mass index Ambulatory blood pressure 

Abbreviations

BP

Blood pressure

ABP

Ambulatory blood pressure

BMI

Body mass index

ERI

Effort–reward imbalance

CVD

Cardiovascular diseases

Notes

Acknowledgments

This research was supported by a grant from the Canadian Institutes of Health Research (CIHR). XT was supported by a CIHR training award and Dr. Brisson was a CIHR Investigator when this work was conducted.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the ethical review board of the CHU de Québec.

Informed consent

Informed consent was obtained from all participants include in this study.

Supplementary material

420_2016_1159_MOESM1_ESM.doc (202 kb)
Supplementary material 1 (DOC 202 kb)

References

  1. Aboa-Eboule C et al (2007) Job strain and risk of acute recurrent coronary heart disease events. JAMA 298(14):1652–1660. doi: 10.1001/jama.298.14.1652 CrossRefGoogle Scholar
  2. Babu GR et al (2014) Is hypertension associated with job strain? A meta-analysis of observational studies. Occup Environ Med 71(3):220–227. doi: 10.1136/oemed-2013-101396 CrossRefGoogle Scholar
  3. Baron RM, Kenny DA (1986) The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Personal Soc Psychology 51:1173–1182CrossRefGoogle Scholar
  4. Berrington de Gonzalez A et al (2010) Body-mass index and mortality among 1.46 million white adults. N Engl J Med 363(23):2211–2219. doi: 10.1056/NEJMoa1000367 CrossRefGoogle Scholar
  5. Block JP, He Y, Zaslavsky AM, Ding L, Ayanian JZ (2009) Psychosocial stress and change in weight among US adults. Am J Epidemiol 170(2):181–192. doi: 10.1093/aje/kwp104 CrossRefGoogle Scholar
  6. Brunner EJ, Chandola T, Marmot MG (2007) Prospective effect of job strain on general and central obesity in the Whitehall II Study. Am J Epidemiol 165(7):828–837CrossRefGoogle Scholar
  7. Chandola T et al (2008) Work stress and coronary heart disease: What are the mechanisms? Eru Heart J 29:640–648CrossRefGoogle Scholar
  8. Claes N (2007) The PreCardio-Study protocol—a randomized clinical trial of a multidisciplinary electronic cardiovascular prevention programme. BMC Cardiovasc disorder 4(7):27CrossRefGoogle Scholar
  9. Daveluy C, Pica L, Audet N, Courtemanche R, Lapointe F (2000) Quebec health and social survey, 2nd edn. Institut de la statistique du Québec, QuébecGoogle Scholar
  10. Dolan E et al (2005) Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study. Hypertension 46(1):156–161CrossRefGoogle Scholar
  11. Efron B (1987) Better bootstrap confidence-intervals. J Am Stat Assoc 82(397):171–185. doi: 10.2307/2289144 CrossRefGoogle Scholar
  12. El-Atat F, Aneja A, McFarlane S, Sowers J (2003) Obesity and hypertension. Endocrinol Metab Clin N Am 32(4):823–854CrossRefGoogle Scholar
  13. Fujishiro K, Lawson CC, Hibert EL, Chavarro JE, Rich-Edwards JW (2015) Job strain and changes in the body mass index among working women: a prospective study. Int J Obes (Lond) 39(9):1395–1400. doi: 10.1038/ijo.2015.91 CrossRefGoogle Scholar
  14. Gilbert-Ouimet M, Brisson C, Vezina M, Milot A, Blanchette C (2011) Repeated effort-reward imbalance exposure, increased blood pressure, and hypertension incidence among white-collar workers. Am J Epidemiol 173:S122Google Scholar
  15. Gilbert-Ouimet M, Trudel X, Brisson C, Milot A, Vezina M (2013) Adverse effects of psychosocial work factors on blood pressure: systematic review of studies on demand-control-support and effort-reward imbalance models. Scand J Work Environ Health. doi: 10.5271/sjweh.3390 Google Scholar
  16. Hayes AF (2009) Beyond baron and kenny: statistical mediation analysis in the new millennium. Commun Monogr. doi: 10.1080/03637750903310360
  17. He FJ, Li J, Macgregor GA (2013) Effect of longer term modest salt reduction on blood pressure: cochrane systematic review and meta-analysis of randomised trials. BMJ 346:f1325. doi: 10.1136/bmj.f1325 CrossRefGoogle Scholar
  18. Inc SI (2000) The SAS system for Sun OS. CaryGoogle Scholar
  19. Kivimaki M et al (2006a) Work stress, weight gain and weight loss: evidence for bidirectional effects of job strain on body mass index in the Whitehall II study. Int J Obes (Lond) 30(6):982–987. doi: 10.1038/sj.ijo.0803229 CrossRefGoogle Scholar
  20. Kivimaki M, Virtanen M, Elovainio M, Kouvonen A, Vaananen A, Vahtera J (2006b) Work stress in the etiology of coronary heart disease-a meta-analysis. Scand J Work Environ Health 32(6):431–442CrossRefGoogle Scholar
  21. Kivimaki M et al (2012) Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data. Lancet 380(9852):1491–1497. doi: 10.1016/S0140-6736(12)60994-5 CrossRefGoogle Scholar
  22. Kouvonen A, Kivimaki M, Cox SJ, Cox T, Vahtera J (2005) Relationship between work stress and body mass index among 45,810 female and male employees. Psychosom Med 67(4):577–583CrossRefGoogle Scholar
  23. Landsberg L et al (2013) Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment: a position paper of the Obesity Society and the American Society of Hypertension. J Clin Hypertens (Greenwich) 15(1):14–33. doi: 10.1111/jch.12049 CrossRefGoogle Scholar
  24. Landsbergis PA, Dobson M, Koutsouras G, Schnall P (2013) Job strain and ambulatory blood pressure: a meta-analysis and systematic review. Am J Public Health 103(3):e61–e71. doi: 10.2105/AJPH.2012.301153 CrossRefGoogle Scholar
  25. Lawes CM, Vander Hoorn S, Rodgers A (2008) Global burden of blood-pressure-related disease, 2001. Lancet 371(9623):1513–1518. doi: 10.1016/S0140-6736(08)60655-8 CrossRefGoogle Scholar
  26. MacKinnon DP, Lockwood CM, Hoffman JM, West SG, Sheets V (2002) A comparison of methods to test mediation and other intervening variable effects. Psychol Methods 7(1):83–104CrossRefGoogle Scholar
  27. Maina G, Bovenzi M, Palmas A, Prodi A, Filon FL (2011) Job strain, effort-reward imbalance and ambulatory blood pressure: results of a cross-sectional study in call handler operators. Int Arch Occup Environ Health 84(4):383–391. doi: 10.1007/s00420-010-0576-5 CrossRefGoogle Scholar
  28. Manolis AJ, Poulimenos LE, Kallistratos MS et al (2014) Sympathetic overactivity in hypertension and cardiovascular disease. Curr Vasc Pharmacol 12(1):4–15CrossRefGoogle Scholar
  29. Mozaffarian D, Benjamin EJ, Go AS, et al (2015) Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circ 131(4):e29–e322CrossRefGoogle Scholar
  30. Niedhammer I, Siegrist J, Landre MF, Goldberg M, Leclerc A (2000) Étude des qualités psychométriques de la version française du modèle du Déséquilibre Efforts/Récompenses. Rev Epidém et Santé Publ 48:419–437Google Scholar
  31. Nyberg ST et al (2013) Job strain and cardiovascular disease risk factors: meta-analysis of individual-participant data from 47,000 men and women. PLoS ONE 8(6):e67323. doi: 10.1371/journal.pone.0067323 CrossRefGoogle Scholar
  32. O’Brien E (2003) The working group on blood pressure monitoring of the European Society of Hypertension. Blood Press Monit 8(1):17–18. doi: 10.1097/01.mbp.0000057011.67622.05 CrossRefGoogle Scholar
  33. O’Brien E, Mee F, Atkins N, O’Malley K (1991) Accuracy of the SpaceLabs 90207 determined by the British Hypertension Society protocol. J Hypertens 9(6):573–574CrossRefGoogle Scholar
  34. O’Brien E et al (2000) Use and interpretation of ambulatory blood pressure monitoring: recommendations of the British hypertension society. BMJ 320(7242):1128–1134CrossRefGoogle Scholar
  35. Peter R, Siegrist J (1997) Chronic work stress, sickness absence, and hypertension in middle managers: General or specific sociological explanations? Soc Sci Med 45(7):1111–1120CrossRefGoogle Scholar
  36. Peter R, Alfredsson L, Hammar N, Siegrist J, Theorell T, Westerholm P (1998) High effort, low reward, and cardiovascular risk factors in employed Swedish men and women: baseline results from the WOLF Study. J Epidemiol Community Health 52(9):540–547CrossRefGoogle Scholar
  37. Peter R, Alfredsson L, Knutsson A, Siegrist J, Westerholm P (1999) Does a stressful psychosocial work environment mediate the effects of shift work on cardiovascular risk factors? Scand J Work Environ Health 25(4):376–381CrossRefGoogle Scholar
  38. Preacher KJ, Hayes AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 40(3):879–891CrossRefGoogle Scholar
  39. Rosengren A et al (2004) Association of psychosocial risk factors with risk of acute myocardial infarction in 11,119 cases and 13,648 controls from 52 countries (the INTERHEART study): case-control study. Lancet 364(9438):953–962CrossRefGoogle Scholar
  40. Rothman KJ, Greenland S, Last TL (2008) Modern epidemiology, 3rd edn. Wolters Kluwer, Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
  41. Santé Québec (1993) Enquête québécoise sur la santé cardiovasculaire [Quebec survey on cardiovascular health] 1990, Rapport finalGoogle Scholar
  42. Siegrist J (1996) Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol 1(1):27–41CrossRefGoogle Scholar
  43. Siegrist J (2003) The model of effort-reward imbalance: measurement. In: http://www.uni-duesseldorf.de/MedicalSociology/index-eri.htm. Accessed 21 June 2006
  44. Siegrist J, Rodel A (2006) Work stress and health risk behavior. Scand J Work Environ Health 32(6):473–481CrossRefGoogle Scholar
  45. Theorell T (2014) Commentary triggered by the Individual Participant Data Meta-Analysis Consortium study of job strain and myocardial infarction risk. Scand J Work Environ Health 40(1):89–95CrossRefGoogle Scholar
  46. Trudel X, Brisson C, Milot A, Masse B, Vezina M (2015) Adverse psychosocial work factors, blood pressure and hypertension incidence: repeated exposure in a 5-year prospective cohort study. J Epidemiol Community Health. doi: 10.1136/jech-2014-204914 Google Scholar
  47. Vrijkotte TGM, Van Doornen LJP, De Geus EJC (2000) Effects of work stress on ambulatory blood pressure, heart rate, and heart rate variability. Hypertension 35(4):880–886CrossRefGoogle Scholar
  48. Whitlock G et al (2009) Body-mass index and cause-specific mortality in 900,000 adults: collaborative analyses of 57 prospective studies. Lancet 373(9669):1083–1096. doi: 10.1016/S0140-6736(09)60318-4 CrossRefGoogle Scholar
  49. Wilson PW, D’Agostino RB, Sullivan L, Parise H, Kannel WB (2002) Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med 162(16):1867–1872CrossRefGoogle Scholar
  50. Xu L, Siegrist J, Cao W, Li L, Tomlinson B, Chan J (2004) Measuring job stress and family stress in Chinese working women: a validation study focusing on blood pressure and psychosomatic symptoms. Women Health 39(2):31–46. doi: 10.1300/J013v39n02_03 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Axe santé des populations et pratiques optimales en santéCentre de recherche FRQS du CHU de QuebecQuebec CityCanada
  2. 2.Département de médecine sociale et préventiveUniversité LavalQuebec CityCanada
  3. 3.Département de médecineUniversité LavalQuebec CityCanada
  4. 4.Département de médecine sociale et préventiveUniversité de MontréalMontrealCanada

Personalised recommendations