Skip to main content
SpringerLink
Log in

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

  • Original Article
  • Published:
International Archives of Occupational and Environmental Health Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • 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 3:21

    Article  Google Scholar 

  • 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

    Google Scholar 

  • Gidlow DA (2004) Lead toxicity. Occup Med (Lond) 54:76–81

    Article  CAS  Google Scholar 

  • 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

    Article  Google Scholar 

  • 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 24:123–142

    Article  Google Scholar 

  • 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 41:165–177

    Article  CAS  Google Scholar 

  • 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

    Google Scholar 

  • 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 46:186–194

    Article  CAS  Google Scholar 

  • 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

    Google Scholar 

  • 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 115:463–471

    Article  CAS  Google Scholar 

  • Lee J (1994) Odds ratio or relative risk for cross-sectional data? Int J Epidemiol 23:201–203

    Article  CAS  Google Scholar 

  • 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

    CAS  Google Scholar 

  • Leigh JP, Du J (2009) Hypertension and occupation among seniors. J Occup Environ Med 51:661–671

    Article  Google Scholar 

  • 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 337:1387–1393

    Article  CAS  Google Scholar 

  • 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 23:449–458

    Article  Google Scholar 

  • 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

    CAS  Google Scholar 

  • 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 64:108–114

    Article  Google Scholar 

  • 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 58:1483–1499

    Article  Google Scholar 

  • 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

    Google Scholar 

  • 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

    CAS  Google Scholar 

  • 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 52:581–586

    Article  CAS  Google Scholar 

  • Thamm M (1999) Blutdruck in Deutschland—Zustandsbeschreibung und Trends (Blood pressure in Germany—Description of situation and trends). Gesundheitswesen (Sonderheft 2): S90–S93

  • 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 110:307–317

    Article  Google Scholar 

  • Wacholder S (1986) Binomial regression in GLIM: estimating risk ratios and risk differences. Am J Epidemiol 123:174–184

    CAS  Google Scholar 

  • 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 289:2363–2369

    Article  Google Scholar 

  • 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 43:10–17

    Article  CAS  Google Scholar 

  • World Health Organisation (2005) The European health report 2005: public health action for healthier children and populations: summary. http://www.euro.who.int/eprise/main/WHO/InformationSources/Publications/Catalogue/20050909_3, Accessed 23 Jan 2010

Download references

Acknowledgments

The CARLA study was funded by a grant from the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG) as part of the Collaborative Research Center 598 “Heart failure in the elderly—cellular mechanisms and therapy” at the Medical Faculty of the Martin-Luther-University Halle-Wittenberg, by a grant of the Wilhelm-Roux Programme of the Martin-Luther-University Halle-Wittenberg, and by the Federal Employment Office.

Conflict of interest

The authors declare that they have no competing interests.

Author information

Author notes

  1. Barbara Schumann

    Present address: Centre for Global Health Research, Umeå University, 90185, Umeå, Sweden

Authors and Affiliations

  1. Federal Institute for Occupational Safety and Health, Berlin, Germany

    Barbara Schumann

  2. Institute and Policlinic for Occupational and Social Medicine, Technical University Dresden, Dresden, Germany

    Andreas Seidler

  3. Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany

    Barbara Schumann, Alexander Kluttig, Johannes Haerting & Karin Halina Greiser

  4. Department of Medicine III, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany

    Karl Werdan

  5. Division of Cancer Epidemiology , German Cancer Research Centre, Heidelberg, Germany

    Karin Halina Greiser

Authors
  1. Barbara Schumann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andreas Seidler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alexander Kluttig
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Karl Werdan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Johannes Haerting
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Karin Halina Greiser
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Barbara Schumann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schumann, B., Seidler, A., Kluttig, A. et al. Association of occupation with prevalent hypertension in an elderly East German population: an exploratory cross-sectional analysis. Int Arch Occup Environ Health 84, 361–369 (2011). https://doi.org/10.1007/s00420-010-0584-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00420-010-0584-5

Keywords

Search

Navigation