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Review
. 2025 Jan 1;51(1):48-52.
doi: 10.5271/sjweh.4196. Epub 2024 Nov 21.

Prevention of hypertension due to long working hours and other work hazards is needed to reduce the risk of cardiovascular disease

Paul Landsbergis  1 , Mahee Gilbert-Ouimet, Xavier Trudel, Grace Sembajwe, Peter Schnall, Marnie Dobson, Devan Hawkins, Marc Fadel, Alexis Descatha, Jian Li
Affiliations
Review

Prevention of hypertension due to long working hours and other work hazards is needed to reduce the risk of cardiovascular disease

Paul Landsbergis et al. Scand J Work Environ Health. .

Abstract

Hypertension is the foremost risk factor for cardiovascular disease (CVD), which is the leading cause of death globally. In some countries, such as the US, the prevalence of hypertension and working-age CVD mortality are increasing. CVD is also the most common work-related disease worldwide. Long working hours and other psychosocial stressors at work are important modifiable risk factors for hypertension and CVD. However, there has been inadequate attention paid to the primary prevention of work-related hypertension and CVD. The state-of-the art method for blood pressure (BP) measurement is 24-hour ambulatory BP (ABP), necessary for accurate clinical decision making and to assess risk factors for BP elevation. Thus, ABP should be used in workplace screening and surveillance programs (along with surveys) to identify occupational risk factors, high-risk job titles, worksites and shifts, and evaluate programs designed to improve work organization. For example, after 30 months of an organizational intervention designed to lower psychosocial stressors at work among >2000 public sector white-collar workers in Quebec, Canada, BP and prevalence of hypertension significantly decreased in the intervention group, with no change in the control group, and a significant difference between the intervention and control groups. Further research is also needed on mechanisms linking work-related factors to hypertension and CVD, the cardiovascular effects of understudied work stressors, high-CVD risk worker groups, potential "upstream" intervention points, and country differences in working conditions, hypertension and CVD. Important organizational interventions, such as collective bargaining, worker cooperatives, or legislative and regulatory-level interventions, need to be evaluated.

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Conflict of interest statement

PL and MD report consulting payments from the Center for Social Epidemiology, Marina Del Rey, CA, USA. PS is Director and MD is Program Director of the Center for Social Epidemiology. GS and JL report grant funding from NIOSH (USA). MF and AD are Editors-in-Chief of an Elsevier series on occupational diseases and the environment. AD reports grant funding from the Université Angers and local and regional government agencies. MGO, XT, DH report no financial conflicts or other conflicts of interest.

Figures

Figure 1
Figure 1
Odds ratio and 95% confidence interval of models of long work hours, hypertension and stroke, unpublished data from the French CONASTANCES cohort, ***P
See this image and copyright information in PMC

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