Association between demand–control model components and blood pressure in the ELSA-Brasil study: exploring heterogeneity using quantile regression analyses
OBJECTIVES: This study aimed to investigate which components of the demand–control model (DCM) are associated with blood pressure (BP) and ascertain whether these associations vary over the BP distribution. METHODS: We evaluated the baseline date of 11 647 current workers enrolled in the Brazilian L...
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Nordic Association of Occupational Safety and Health (NOROSH)
2018-11-01
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doaj-5109a01934b44519bdad088f297394152021-04-21T06:56:59ZengNordic Association of Occupational Safety and Health (NOROSH)Scandinavian Journal of Work, Environment & Health0355-31401795-990X2018-11-0144660161210.5271/sjweh.37553755Association between demand–control model components and blood pressure in the ELSA-Brasil study: exploring heterogeneity using quantile regression analysesLeidjaira Lopes JuvanholEnirtes Caetano Prates MeloDóra ChorMaria de Jesus Mendes FonsecaLúcia RotenbergLeonardo Soares BastosJosé Geraldo MillRosane Härter Griep0Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.OBJECTIVES: This study aimed to investigate which components of the demand–control model (DCM) are associated with blood pressure (BP) and ascertain whether these associations vary over the BP distribution. METHODS: We evaluated the baseline date of 11 647 current workers enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) (2008–2010), a multicenter cohort study of 35–74-year-old civil servants. Job demands, skill discretion and decision authority were measured using the Brazilian version of the Demand–Control–Support Questionnaire. The associations between DCM components and systolic and diastolic BP (SBP and DBP, respectively) were examined by gamma regression, indicated for modelling skewed continuous variables, and quantile regression. Tests were conducted for interaction with gender and use of antihypertensives. RESULTS: In the adjusted gamma models, no association was observed between DCM components and BP in the total study population. Among non-users of antihypertensives, high decision authority was marginally associated with an increase of 0.59 mmHg (95% CI 0.00–1.18) in SBP. In the quantile models, this association was found to be significant from quantiles 35–60. Further significant but inconsistent positive associations were observed between decision authority and DBP among users of antihypertensives (quantiles 5 and 10) and between skill discretion and SBP in the total study population (quantile 5). The results did not differ by gender. CONCLUSIONS: Decision authority associates positively with SBP, but only in the central portion of the SBP distribution and among non-users of antihypertensives. No consistent associations were observed for skill discretion or job demands. https://www.sjweh.fi/show_abstract.php?abstract_id=3755 job strainhypertensionjob controljob demandheterogeneitydemand–control modeldemand–controlkarasekelsa-brasilquantile regression analysispsychological stressblood pressure |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Leidjaira Lopes Juvanhol Enirtes Caetano Prates Melo Dóra Chor Maria de Jesus Mendes Fonseca Lúcia Rotenberg Leonardo Soares Bastos José Geraldo Mill Rosane Härter Griep |
spellingShingle |
Leidjaira Lopes Juvanhol Enirtes Caetano Prates Melo Dóra Chor Maria de Jesus Mendes Fonseca Lúcia Rotenberg Leonardo Soares Bastos José Geraldo Mill Rosane Härter Griep Association between demand–control model components and blood pressure in the ELSA-Brasil study: exploring heterogeneity using quantile regression analyses Scandinavian Journal of Work, Environment & Health job strain hypertension job control job demand heterogeneity demand–control model demand–control karasek elsa-brasil quantile regression analysis psychological stress blood pressure |
author_facet |
Leidjaira Lopes Juvanhol Enirtes Caetano Prates Melo Dóra Chor Maria de Jesus Mendes Fonseca Lúcia Rotenberg Leonardo Soares Bastos José Geraldo Mill Rosane Härter Griep |
author_sort |
Leidjaira Lopes Juvanhol |
title |
Association between demand–control model components and blood pressure in the ELSA-Brasil study: exploring heterogeneity using quantile regression analyses |
title_short |
Association between demand–control model components and blood pressure in the ELSA-Brasil study: exploring heterogeneity using quantile regression analyses |
title_full |
Association between demand–control model components and blood pressure in the ELSA-Brasil study: exploring heterogeneity using quantile regression analyses |
title_fullStr |
Association between demand–control model components and blood pressure in the ELSA-Brasil study: exploring heterogeneity using quantile regression analyses |
title_full_unstemmed |
Association between demand–control model components and blood pressure in the ELSA-Brasil study: exploring heterogeneity using quantile regression analyses |
title_sort |
association between demand–control model components and blood pressure in the elsa-brasil study: exploring heterogeneity using quantile regression analyses |
publisher |
Nordic Association of Occupational Safety and Health (NOROSH) |
series |
Scandinavian Journal of Work, Environment & Health |
issn |
0355-3140 1795-990X |
publishDate |
2018-11-01 |
description |
OBJECTIVES: This study aimed to investigate which components of the demand–control model (DCM) are associated with blood pressure (BP) and ascertain whether these associations vary over the BP distribution. METHODS: We evaluated the baseline date of 11 647 current workers enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) (2008–2010), a multicenter cohort study of 35–74-year-old civil servants. Job demands, skill discretion and decision authority were measured using the Brazilian version of the Demand–Control–Support Questionnaire. The associations between DCM components and systolic and diastolic BP (SBP and DBP, respectively) were examined by gamma regression, indicated for modelling skewed continuous variables, and quantile regression. Tests were conducted for interaction with gender and use of antihypertensives. RESULTS: In the adjusted gamma models, no association was observed between DCM components and BP in the total study population. Among non-users of antihypertensives, high decision authority was marginally associated with an increase of 0.59 mmHg (95% CI 0.00–1.18) in SBP. In the quantile models, this association was found to be significant from quantiles 35–60. Further significant but inconsistent positive associations were observed between decision authority and DBP among users of antihypertensives (quantiles 5 and 10) and between skill discretion and SBP in the total study population (quantile 5). The results did not differ by gender. CONCLUSIONS: Decision authority associates positively with SBP, but only in the central portion of the SBP distribution and among non-users of antihypertensives. No consistent associations were observed for skill discretion or job demands. |
topic |
job strain hypertension job control job demand heterogeneity demand–control model demand–control karasek elsa-brasil quantile regression analysis psychological stress blood pressure |
url |
https://www.sjweh.fi/show_abstract.php?abstract_id=3755
|
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