Job strain and arterial hypertension in nursing professionals from the municipal healthcare network in Belo Horizonte, Minas Gerais, Brazil

Pimenta, Adriano Marçal; Assunção, Ada Ávila

doi:10.1590/2317-6369000113515

Brasil

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Article • Rev. bras. saúde ocup. 41 • 2016 • https://doi.org/10.1590/2317-6369000113515 linkcopy

Job strain and arterial hypertension in nursing professionals from the municipal healthcare network in Belo Horizonte, Minas Gerais, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective: to assess the association between job strain and arterial hypertension (AH).

Method: cross-sectional study with random sample of 273 nursing professionals from the municipal healthcare network in Belo Horizonte, Minas Gerais, Brazil, conducted between September 2008 and January 2009. Job strain was measured using the demand-control model and hypertension by self-report medical diagnosis of the disease or use of antihypertensive medication. Prevalence ratios (PR) of AH and their respective 95% confidence intervals (95% CI) were adjusted by Poisson multivariate regression.

Results: among the professionals studied, 42.1% were nurses and 57.8% were nursing technicians or assistants. The AH was diagnosed in 16.9%. Female sex (PR = 0.56), increasing age (p of linear trend < 0.001), household income of 4 or more minimum wages (PR = 0.39) and job strain (PR = 2.53) were independently associated to AH after the multivariate adjustment.

Conclusions: job strain is associated with AH among nursing professionals from the municipal healthcare network in Belo Horizonte. This finding must be considered in the formulation of public policies involving the health promotion of these workers.

Keywords: job strain; hypertension; nursing

Characteristics	Population			Hypertension
	n (%)	%	PR	95% CI	p-value^*
Sex					0.149
Male	26 (9.5)	26.9	1.00	-
Female	247 (90.5)	15.8	0.59	0.29-1.18
Age (years)					< 0.001^†
20-39	123 (45.1)	5.7	1.00	-
40-49	97 (35.5)	18.6	3.26	1.42-7.50
50 or more	53 (19.4)	39.6	6.96	3.15-15.40
Skin color^‡					0.032
White	97 (35.5)	10.3	1.00	-
Nonwhite	176 (64.5)	20.5	1.98	1.02-3.83
Marital status					0.826
Single	87 (31.9)	16.1	1.00	-
Married/Law marriage	141 (51.7)	16.3	1.02	0.55-1.86
Divorced/Widowed	45 (16.5)	20	1.24	0.58-2.65
Household income (minimum wages)					0.026^†
Up to 2	75 (27.5)	17.3	1.00	-
2 to 4	116 (42.5)	22.4	1.29	0.71-2.36
4 or more	82 (30)	8.5	0.49	0.21-1.17
Smoking					0.115
Non-smoker	193 (70.7)	14	1.00	-
Former smoker	50 (18.3)	26	1.86	1.04-3.34
Current smoker	30 (11)	20	1.43	0.64-3.18
Problems with alcohol					0.928
No	256 (93.8)	15.8	1.00	-
Yes	17 (6.2)	18.6	1.18	0.69-2.01
Physical activity (times/week)					0.574^†
Never	152 (55.7)	15.8	1.00	-
1 to 2	75 (27.5)	17.3	0.89	0.41-1.91
3 or more	46 (16.9)	19.6	0.81	0.40-1.61

Characteristics			Population	Hypertension
	n (%)	%	PR	95% CI	p-value^*
Night work					0.817
No	198 (72.5)	17.2	1.00	-
Yes	75 (27.5)	16	0.93	0.51-1.70
Workload (hours/week)					0.539
Up to 40	149 (54.6)	18.1	1.00	-
More than 40	124 (45.4)	15.3	0.86	0.49-1.45
Time in current job (months)					0.018^†
< 24	54 (19.8)	9.3	1.00	-
24 to 47	68 (24.9)	10.3	1.11	0.37-3.31
≥ 48	151 (55.3)	22.5	2.43	1.00-5.91
Social support					0.346
High	136 (49.2)	14.7	1.00	-
Low	137 (50.2)	19	1.29	0.76-2.20
Professional category					0.001
Nurses	115 (42.1)	7.8	1.00	-
Technicians/assistants	158 (57.9)	23.4	2.99	1.50-5.96
Level of care					0.058
Primary	188 (68.9)	16	1.00	-
Secondary	85 (31.1)	18.8	1.18	0.68-2.04
Demand-control					0.010
Low strain	65 (23.8)	9.2	1.00	-
Active	64 (23.4)	9.4	1.02	0.35-2.99
Passive	91 (33.3)	20.9	2.26	0.95-5.36
High strain	53 (19.4)	28.3	3.07	1.28-7.36
Obesity diagnosis					0.344
No	232 (85.0)	16.0	1.00	-
Yes	41 (15.0)	22.0	1.38	0.72-2.64

Characteristics	PR	95% CI	p-value^*
Sex
Male	1.00	-	-
Female	0.56	0.32-0.99	0.046
Age (years)			< 0.001^†
20-39	1.00	-	-
40-49	3.69	1.60-8.53	0.002
50 or more	7.49	3.32-16.85	< 0.001
Skin color^‡
White	1.00	-	-
Nonwhite	1.53	0.81-2.86	0.187
Household income (minimum wages)^§			0.035^†
Up to 2	1.00	-	-
2 to 4	0.73	0.40-1.32	0.296
4 or more	0.39	0.18-0.88	0.023
Smoking^**
Non-smoker	1.00	-	-
Former smoker	1.01	0.54-1.90	0.978
Current smoker	1.15	0.56-2.37	0.706
Demand-control^**
Low strain	1.00	-	-
Active	1.08	0.40-2.97	0.888
Passive	1.69	0.72-3.91	0.226
High strain	2.53	1.03-6.20	0.042
Professional category^**
Nurses	1.00	-	-
Technicians/assistants	1.57	0.70-3.52	0.276
Level of care^**
Primary	1.00	-	-
Secondary	1.06	0.64-1.75	0.819

Characteristics	PR	95% CI	p-value^*
Age (years)			< 0.001^†
20-39	1.00	-	-
40-49	4.69	1.68-12.04	0.003
50 or more	10.45	3.62-30.14	< 0.001
Skin color^‡
White	1.00	-	-
Nonwhite	1.56	0.76-3.23	0.229
Household income (minimum wages)			0.189^†
Up to 2	1.00	-	-
2 to 4	0.71	0.34-1.48	0.354
4 or more	0.40	0.17-0.94	0.035
Smoking^**
Non-smoker	1.00	-	-
Former smoker	1.02	0.46-2.28	0.953
Current smoker	1.27	0.56-2.86	0.570
Demand-control^**
Low strain	1.00	-	-
Active	0.89	0.30-2.66	0.841
Passive	1.66	0.62-4.49	0.316
High strain	2.36	1.01-6.46	0.047
Professional category^**
Nurses	1.00	-	-
Technicians/assistants	1.60	0.72-3.55	0.243
Obesity diagnosis^**
No	1.00	-	-
Yes	1.75	0.86-3.56	0.122

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[TFN17] Note: *p-value of Pearson's chi-squared test;

[TFN18] †p-value of chi-squared test of linear trend;

[TFN19] ‡Nonwhite skin color = brown, black, yellow, indigenous.