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



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).


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.


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.


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.


Work stress Body mass index Ambulatory blood pressure 



Blood pressure


Ambulatory blood pressure


Body mass index


Effort–reward imbalance


Cardiovascular diseases



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)


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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

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