The impact of job strain and marital cohesion on ambulatory blood pressure during 1 year: the double exposure study.

BACKGROUND Psychosocial and lifestyle stressors, such as job strain and marital factors, have previously been associated with a sustained increase in blood pressure (BP). METHODS In a 1-year longitudinal study, we evaluated whether job strain and marital cohesion continued to be associated with ambulatory blood pressure (ABP). The final study cohort included 229 male and female volunteers who were still employed and living with a significant other as at baseline and could complete all aspects of the follow-up testing. RESULTS The interaction between job strain and marital cohesion was significantly associated with a change in ABP during 1 year for 24-h systolic BP but not diastolic BP (P = .018 and .13, respectively). This association also occurred for job strain (P = .011). Subjects with high job strain and a low cohesive marriage had an increase in systolic BP by 3 mm Hg during 1 year, and those with job strain who also had a highly cohesive marriage had a reduction of systolic BP by 3 mm Hg during 1 year. An exploratory analysis for gender effects found that the interaction between job strain and marital cohesion was found only in women (P = .025). CONCLUSIONS Marital cohesion consistently interacted with the sustained elevation of BP associated with job strain over time in men and women. Low marital cohesion exacerbated the effect of job strain to elevate BP and high marital cohesion ameliorated it. This interaction may be gender specific in that it was demonstrated separately in women but not in men.