Job strain in men, but not in women, predicts a significant rise in blood pressure after 6.5 years of follow-up.

Background: Job strain (high demands and low decision latitude) has been associated with hypertension and cardiovascular disease, especially in men. Most studies on job strain and hypertension have been cross-sectional, and prospective data are inconsistent.

Objective: To prospectively describe the effects of different psychosocial work characteristics on office blood pressure changes.

Methods: In total, 448 men and women, mean age 55 years, were followed for a mean of 6.5 years. At baseline, work characteristics and cardiovascular risk factors were assessed. Only employed subjects aged 63 years or younger were eligible for participation.

Results: Men with baseline job strain had a significantly greater increase in both systolic blood pressure (7.7 mmHg, P = 0.02), and diastolic blood pressure (5.6 mmHg, P = 0.003), compared to the group with low work demands and high decision latitude ('relaxed'). These findings were significant also after adjustments for age, follow-up time, baseline blood pressure, blood pressure treatment at baseline and follow-up, and length of education. Work demands were more strongly correlated with blood pressure increase than decision latitude. For women, no significant associations between psychosocial work characteristics and blood pressure changes were found, apart from a weak trend of association between increasing decision latitude and increasing blood pressure.

Conclusion: Job strain significantly predicts an increase in office blood pressure in middle-aged men, but not in women. Work demands were more strongly correlated with blood pressure increase than decision latitude in men.