Perceived Job Stress and Presence of Hypertension Among Administrative Officers in Sri Lanka

Hypertension in Sri Lanka: a systematic review of prevalence, control, care delivery and challenges

Hypertension (HTN) is recognized as a major modifiable risk factor for cardiovascular deaths in South Asia. Our aim was to furnish a comprehensive analysis of HTN prevalence, trends, control efforts, awareness, barriers in care delivery and associated factors, based on nationally derived evidence in Sri Lanka. A systematic search of online databases ( PubMed, Web of Science, Scopus ), local journals and repositories yielded 6704 results, of which 106 were included. Prevalence of HTN steadily increased from 23.7% (2005-2006) to 34.8% (2021). Associated factors identified were hyperhomocysteinaemia [odds ratio (OR) 2.80], overweight/obesity (OR 2.02), perceived job stress (OR 2.20-3.02), physical inactivity (OR 2.08-2.80), salt intake more than 5 g/day (OR 2.50), smoking (OR 2.31) and waist-to-height ratio more than or equal to 0.5 (OR 2.23). Cohort studies revealed poor blood pressure control and treatment adherence among patients. Pharmacological ( n  = 4) and nonpharmacological ( n  = 6) interventional studies were few. Studies on knowledge, attitudes and practices demonstrated a lack of public awareness. Despite the high prevalence of HTN in Sri Lanka, many cases remain undiagnosed, underscoring importance of targeted screening programmes and culture-specific public health education programmes.

Physical inactivity, and its association with hypertension among employees in the district of Colombo

BACKGROUND

Physical inactivity is a leading cause of morbidity and mortality and is a major public health problem. Insufficient activity is responsible for a large proportion of non-communicable diseases such as hypertension.

OBJECTIVES

The purpose of this study was to assess socioeconomic variations in physical activity and to measure the association between physical inactivity and hypertension among government officials in Sri Lanka.

METHODS

A cross-sectional study was carried out among 275 senior-officers(SOs) and 760 managerial-assistants(MAs) aged 30-60 years and attached to Public Administration institutions in Colombo District in Sri Lanka. Physical-activity(PA) was gathered using the International Physical Activity Questionnaire(IPAQ) adopted and validated to the Sri Lankan context. Blood pressure(measured and classified using JNC-7 guidelines) and anthropometric indices were recorded. Energy utilization of all vigorous and moderated PA and walking was expressed as metabolic-equivalent-of-task(MET) min per week. A total-MET-score was calculated and categorized based on IPAQ guidelines.

RESULTS

Socioeconomic variations in PA levels were observed as 58.1%(n = 158) SOs and 30.6%(n = 226) MAs were involved in inadequate PA. Among the SOs diagnosed with hypertension, more half(59.1%; n = 52) were physically inactive, while among MAs, 65.9%(n = 143) with hypertension were physically inactive. After adjusting for potential confounding factors being physically inactive was associated with a higher risk of hypertension among SOs[OR 2.08 [95% CI 1.07, 4.6] and MAs[OR 2.8 [95% CI 1.8, 4.6]. The main modality of commuting to work for SOs(59%) was private transport, and MAs(64%) public transport Commuting distance was positively correlated(p < 0.05) with total transport MET among SOs and MAs. After adjusting for confounders, commuting distance of > 20 km was found to lower the odds of hypertension among SOs and MAs(OR = 0.713; 95% CI 0.4 to1.3; and OR = 0.63; 95% CI 0.46 to 0.87).

CONCLUSION

Despite the current knowledge that being physically active promotes health, the practice was different. Physical inactivity was associated with hypertension and prevalent among both SOs and MAs. Higher commuting distance is positively correlated with total transport MET and associated with lower odds of hypertension among SOs and MAs. Longitudinal studies are required to provide a causative association between physical inactivity and hypertension among these employees.

The burden of hypertension and unmet need for hypertension care among men aged 15-54 years: a population-based cross-sectional study in India

Hypertension is one of the primary causes of morbidity and premature mortality among the working-age population in India. This study evaluated the burden of hypertension and unmet need for hypertension care among working-age men aged 15-54 years in India using data from the fourth round of the National Family Health Survey (NFHS-4, 2015-16). An individual was recognized as hypertensive if his blood pressure was over 140/90 mmHg or if he was consuming anti-hypertensive medication to lower his blood pressue. The study design was based on the Rule of Halves framework. Hypertensive cases were segmented into five analytical levels: (1) total, (2) screened, (3) diagnosed, (4) treated and (5) controlled cases. The prevalence of hypertension was 16% (n=16,254) among the men aged 15-54 years. Of the total hypertensive individuals, 63.2% (10,314) were screened, 21.5% (3428) were diagnosed, 12.6% (1862) were treated and only 6.1% (905) had controlled blood pressure. Of the screened individuals, 66.8% (6886) had never been diagnosed, 45.7% (1566) of those diagnosed had not receive treatment and 51.4% (957) of those treated still had uncontrolled blood pressure. The analyses revealed that 36.5% (5940) of hypertensive individuals were lost at the screening stage. The results demonstrate that there is a significant burden of hypertension and unmet need for hypertension care among men aged 15-54 in India. There is an urgent need to develop suitable strategies and programmes to manage this rising burden of hypertension among men, and reduce losses in the hypertension care continuum.

Self-Reported Modifiable Risk Factors of Cardiovascular Disease among Seafarers: A Cross-Sectional Study of Prevalence and Clustering

BACKGROUND

Cardiovascular diseases (CVD) are the major cause of work-related mortality from diseases onboard ships in seafarers. CVD burden derives mainly from modifiable risk factors. To reduce the risk factors and the burden of CVD onboard ships in seafarers, it is important to understand the up-to-date prevalence of modifiable risk factors. The primary purpose of this study was to assess the prevalence and clustering of self-reported modifiable CVD risk factors among seafarers. We have also explored the association between socio-demographic and occupational characteristics and reported modifiable CVD risk factor clustering.

MATERIALS AND METHODS

A cross-sectional study was conducted among seafarers from November to December 2020 on board ships. In total, 8125 seafarers aged 18 to 70 were selected from 400 ships. Data were collected using a standardized and anonymous self-reported questionnaire. The prevalence value for categorical variables and mean differences for continuous variables were compared using chi-square and independent sample t-tests. Multinomial logistic regression models were performed to identify independent predictors for modifiable CVD risk factor clustering.

RESULTS

Out of a total of 8125 seafarers aged ≥18 years on selected vessels, 4648 seafarers volunteered to participate in the survey, with a response rate of 57.2%. Out of 4318 participants included in analysis, 44.7% and 55.3% were officers and non-officers, respectively. The prevalence of reported hypertension, diabetes, current smoking and overweight or obesity were 20.8%, 8.5%, 32.5%, and 44.7%, respectively. Overall, 40%, 20.9%, 6% and 1.3% of the study participants respectively had one, two, three and four modifiable CVD risk factors. Older age (51+ years) (odds ratio (OR): 3.92, 95% confidence interval (CI): 2.44-6.29), being non-officers (OR: 1.36, 95% CI: 1.09-1.70), job duration (10-20 years) (OR: 2.73, 95% CI: 2.09-3.57), job duration (21+ years) (OR: 2.60, 95% CI: 1.79-3.78), working 57-70 h per week (OR: 2.03, 95% CI: 1.65-2.49) and working 71+ h per week (OR: 3.08, 95% CI: 2.42-3.92) were independent predictors for at least two self-reported modifiable CVD risk factor clustering.

CONCLUSION

The results of our study demonstrate that more than four in six (68.5%) seafarers aged between 19 and 70 years have at least one of the modifiable CVD risk factors. Therefore, CVD prevention and modifiable risk factors reduction strategies targeting high-risk groups should be designed and implemented on board ships.

Exposure to Indoor Volatile Organic Compounds and Hypertension among Thin Film Transistor Liquid Crystal Display Workers

This cross-sectional study aimed to determine the concentration of indoor volatile organic compounds (VOCs) and to investigate the association between indoor VOCs exposure and the prevalence of hypertension among thin film transistor liquid crystal display (TFT-LCD) workers. A total of 20 canisters were used to collect VOCs samples in the array, cell and module areas over 12 hours and VOCs concentrations were analyzed by the gas chromatography with mass spectrum. Individual information of health examination and lifestyles by self-administrated questionnaire were provided by 155 volunteers. The multivariate regression models were used to evaluate the associations between VOCs exposure, blood pressure and the prevalence of hypertension. The four dominant VOCs were ethanol (1870.8 ± 1754.0 ppb), acetone (689.9 ± 587.4 ppb), isopropyl alcohol (177.1 ± 202.3 ppb) and propylene glycol monomethyl ether acetate (98.2 ± 100.8 ppb), which were identified with the highest level in the module area for ethanol and acetone and in the array area for the others. Subjects exposed to a total level of ethanol, cyclohexanone and toluene ≥ 2500 ppb had an increased systolic blood pressure of 5.95 mmHg (95% confidence interval: 0.20–11.71; p = 0.043) compared with those exposed to <2500 ppb. Exposure to mixed VOCs in the indoor environment might be associated with elevated blood pressure among TFT-LCD workers.

Association of glucocorticoid receptor gene polymorphism and occupational stress with hypertension in desert petroleum workers in Xinjiang, China

Background

The aim of this study was to investigate the occupational stress and hypertension in desert petroleum workers in Xinjiang, and to analyze the association of occupational stress and glucocorticoid receptor (GR) gene polymorphism with the presence of hypertension.

Methods

Using cluster sampling, 1280 desert petroleum workers of 3 petroleum fields in Xinjiang Karamay were randomly selected as the target group for this study. According to the inclusion criteria, a total of 1080 workers were included as the baseline for this study. We followed these workers for 2 years to investigate their occupational stress and hypertension. The polymorphism of GR gene was detected by polymerase chain reaction-restriction fragment length polymorphism. We applied appropriate statistical methods to analyze the association of occupational stress and glucocorticoid receptor (GR) gene polymorphism with the presence of hypertension.

Results

After 2 years of follow-up, there were 995 desert petroleum workers in the queue. The study showed that the incidence of hypertension in desert petroleum workers were 19.4%. Compared with the baseline data, the level of occupational stress increased, and with the increase of occupational stress, the incidence of hypertension was gradually increasing. A positive relationship was observed in the GR BCL1 gene polymorphisms and hypertension. Relative to the CC genotype, carries of the GG genotype had a significantly higher risk of hypertension (OR = 2.830). With the combination of genotype CG and GG, carries of CG and GG increased the risk of hypertension (adjusted OR = 2.238, 95%CI:1.104–4.940). There was no significant association between GR G678S gene polymorphisms and hypertension.

Conclusion

GR gene polymorphism and occupational stress of desert petroleum workers were important risk factors for hypertension.

Comparison of characteristics and outcomes of percutaneous coronary intervention in military and non-military men

OBJECTIVES

Living in a military environment, as a unique job and lifestyle, may affect the physical and mental status of military personnel. Coronary artery disease (CAD) status and outcomes of percutaneous coronary intervention (PCI) in military personnel as a unique part of each society are less investigated.

METHOD

In a registry-based study, data of 338 military men and 1954 non-military men who underwent successful PCI from March 2012 to March 2013 were analysed. The primary endpoint was major adverse cardiac events (MACE) after hospital discharge during 1-year follow-up.

RESULTS

Military men were significantly younger and had a higher frequency of hypertension, familial history of CAD and cigarette smoking. Other risk factors were more prevalent in non-military men. PCI for ST-segment elevation myocardial infarction and lower left ventricular ejection fraction were also more prevalent in soldiers. After mean follow-up duration of 12.3 months, MACE that was defined as the composite endpoint of all-cause mortality, non-fatal myocardial infarction or target vessel revascularisation was similar in both groups (HR=1.01 (95% CI 0.88 to 1.16); p=0.872). By adjustment for confounding factors, results were unchanged.

CONCLUSIONS

Although there are a number of differences in basic and procedural characteristics between military and non-military men who underwent PCI, 1-year clinical outcomes of this procedure are not different in these patient groups.