Adverse effects of psychosocial work factors on blood pressure: systematic review of studies on demand–control–support and effort–reward imbalance models

Abstract

This is the first systematic review and critical synthesis on the adverse effects of psychosocial work factors of the demand-control-support and effort-reward imbalance models on blood pressure. A more consistent effect has been observed among men than women and among studies of higher methodological quality. Evidence-based guidelines for cardiovascular diseases prevention may benefit from these findings.Affiliation: Population health research unit, St-Sacrement hospital,

Job control and ambulatory blood pressure

“…Workers with low job control have been found to have higher BP than those with high job control (6,8). However, inconsistent associations have been found between this exposure and outcome.…”

“…However, inconsistent associations have been found between this exposure and outcome. For instance, only half of the relevant studies reviewed by Gilbert-Ouimet et al (6) showed a significant protective effect for high job control. Furthermore, job control is beneficial to nocturnal systolic BP (SBP) dipping (9), an important physiological function (10,11) as night-time BP is a compelling predictor of cardiovascular mortality (12).…”

Commentary

“…According to a recent systematic review (13), job strain is associated with elevated blood pressure, one of the classical standard risk factors. There are divided opinions regarding this relationship with regard to blood pressure assessed in the classical way (at rest in the "doctor's office") but the relationship is more established for blood pressure that has been automatically monitored during normal daily activities (14).…”

A modified Job Demand, Control, Support model for active duty police

“…In the late 1980's Johnson (17) proposed a modification to the JDC model and suggested that social support should be added as a third dimension. The Job Demand-Control-Support (JDCS) model has since become one of the most widely studied theoretical approaches used to investigate the psychosocial work environment and has been widely used in medical and psychological research to investigate a variety of health measures including; fatigue and job satisfaction which have been identified as problem areas for Swedish police (18)(19)(20)(21)(22)(23)(24).…”

“…Previous research into the health and wellbeing of police has identified several factors that negatively affect the psychosocial health of police and could potentially be incorporated into an occupation specific JDCS model. Those most frequently cited are shift work (27) and harassment and threats of violence (9) Shift work has been associated with a number of adverse health outcomes in a variety of professional groups, including higher levels of work stress (4,8,25), increased risk of cardiovascular disease (17,20,25), fatigue (21,(28)(29)(30)(31) and on-duty injury (3). Shift work in the police force has specifically been associated with a higher incidence of work-related stressors (27), poor sleep quality (5,32,33), increased systolic blood pressure (34) and a higher risk of workplace injury (1,35).…”