Increases in job strain are associated with incident hypertension in the CARDIA Study

Ann Behav Med. 2004 Aug;28(1):4-9. doi: 10.1207/s15324796abm2801_2.


Background: Job strain, defined as high job demands and low decision latitude, has been associated with increased blood pressure levels in some studies, but most of these studies have been cross-sectional.

Purpose: We sought to determine whether changes in job strain during young adulthood were associated with the development of hypertension, using the Coronary Artery Risk Development in Young Adults cohort.

Methods: A total of 3,200 employed, initially normotensive participants, aged 20 to 32 in 1987-1988, were followed for 8 years; the Job Content Questionnaire was completed twice: initially and 8 years later. Hypertension at follow-up was defined as systolic blood pressure (SBP) of 160 or higher and diastolic blood pressure of 95 mmHg or higher, or reporting being on antihypertensive medication.

Results: Job strain (based on job demands above the median and decision latitude below the median of the sample) was associated with hypertension incidence (ps <.05) for the entire cohort and among White women and men. Adjustment for baseline SBP, education, body mass index (BMI), change in BMI, and age did not alter these relations. The ratio of increasing demands relative to decreasing decision latitude was also associated with greater incidence of hypertension in the entire cohort in the multivariate model (odds ratio = 2.06, 95% confidence interval = 1.01-4.26).

Conclusions: An increase in job strain is associated with incident hypertension, particularly among Whites.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Age Factors
  • Body Mass Index
  • Cohort Studies
  • European Continental Ancestry Group*
  • Female
  • Humans
  • Hypertension / etiology*
  • Hypertension / psychology*
  • Job Description*
  • Male
  • Stress, Psychological / complications*
  • Workplace*