Job Strain, Occupational Category, Systolic Blood Pressure, and Hypertension Prevalence: The Multi-Ethnic Study of Atherosclerosis

Objective: To assess associations of occupational categories and job characteristics with prevalent hypertension. Methods: We analyzed 2517 Multi-Ethnic Study of Atherosclerosis participants, working 20+ hours per week, in 2002 to 2004. Results: Higher job decision latitude was associated with a lower prevalence of hypertension, prevalence ratio = 0.78 (95% confidence interval 0.66 to 0.91) for the top versus bottom quartile of job decision latitude. Associations, however, differed by occupation: decision latitude was associated with a higher prevalence of hypertension in health care support occupations (interaction P = 0.02). Occupation modified associations of sex with hypertension: a higher prevalence of hypertension in women (vs men) was observed in health care support and in blue-collar occupations (interaction P = 0.03). Conclusions: Lower job decision latitude is associated with hypertension prevalence in many occupations. Further research is needed to determine reasons for differential impact of decision latitude and sex on hypertension across occupations.