Hypertension Clinical Trial
To analyze the association between an objective measure of "job strain" and risk of stroke, and change in ambulatory blood pressure.
BACKGROUND:
Cardiovascular disease accounts for 43 percent of all deaths in the United States.
Hypertension affects as many as 50 million Americans, however the causes of essential
hypertension are not well known. A new CVD risk factor ("job strain") has emerged as a
potential major cause of essential hypertension. By 1995, over 20 studies had found
significant positive relationships between "job strain" and CVD, coronary heart disease,
all-cause mortality or hypertension. "Job strain" is defined as high psychological workload
demands combined with low"decision latitude". An expanded concept of "job strain" which
included low workplace social support ("iso-strain") was developed and examined in the
study.
Important questions remained to be answered about "job strain", CVD and hypertension. In
most studies, "job strain" was only measured at one point in time, while, in fact,
cumulative exposure to "job strain" was believed to be the risk factor. In addition, most
studies relied on self-report measures of "job strain". Also, no studies specifically
examined risk of stroke and "job strain".
DESIGN NARRATIVE:
Data from the Cornell University cohort study of Psychosocial Factors and Cardiovascular
Disease and the Columbia University-Northern Manhattan Stroke Study were analyzed. The study
had five specific aims, including to determine whether: blood pressure levels were
associated with cumulative exposure to "job strain"; differences in blood pressure increases
were associated with an objective measure of "job strain"; increased risk of stroke was
associated with an objective measure of "job strain"; changes in psychological variables
over time were associated with job characteristics; changes in CVD risk factors (other than
hypertension) were associated with job characteristics.
Paul Landsbergis also constructed measures of cumulative exposure to "job strain" and
determined their association with blood pressure, and analyzed the association between job
characteristics and change in psychological variables and cardiovascular disease (CVD) risk
factors.
The study completion date listed in this record was obtained from the "End Date" entered in
the Protocol Registration and Results System (PRS) record.
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