The Association Between Life Events and Incidence of Hypertension Among Government Employees in China: A Prospective Cohort Study

Feiyun Ouyang; Jun He; Xunjie Cheng; Dan Qiu; Ling Li; Joseph Benjamin Bangura; Yanyin Duan; Dan Luo; Shuiyuan Xiao

doi:10.3389/fpsyg.2022.822610

The Association Between Life Events and Incidence of Hypertension Among Government Employees in China: A Prospective Cohort Study

Front Psychol. 2022 May 30:13:822610. doi: 10.3389/fpsyg.2022.822610. eCollection 2022.

Authors

Feiyun Ouyang^{1

2}, Jun He^{1

2}, Xunjie Cheng³, Dan Qiu^{1

2}, Ling Li^{1

2}, Joseph Benjamin Bangura^{1

2}, Yanyin Duan^{2

4}, Dan Luo^{1

2}, Shuiyuan Xiao^{1

2}

Affiliations

¹ Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.
² Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China.
³ Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha, China.
⁴ Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, China.

Abstract

Background: Hypertension (HTN) is a global public health concern. However, the association between life events (LEs) and HTN is complex. Thus, we conducted a prospective cohort study to explore this complex association.

Methods: A total of 8,077 government employees without HTN were recruited through cluster sampling between 2018 and 2019 in Hunan Province, China. At baseline, information regarding sociodemographic characteristics, LEs, and behavioral factors was collected. After the 1-year follow-up, the participants were revisited to obtain the HTN diagnosis. Crude and adjusted Poisson regression models were constructed to calculate the incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Cubic regression spline models were used to visualize the trends between LEs and HTN IRRs. Interactive and subgroup analyses were also performed.

Results: The 1-year HTN incidence rate among government employees in Hunan province was 4.30% (95% CI: 3.86-4.74%). LEs were associated with a higher HTN risk (IRR, 1.02; 95% CI, 1.00-1.04). When calculating positive and negative LEs scores separately, only the latter was a risk factor for HTN incidence (IRR, 1.04; 95% CI, 1.03-1.06); conversely, positive LEs reduced the risk (IRR, 0.90; 95% CI, 0.85-0.96). Compared with patients in the lowest quartile of LEs score, those in quartiles two (IRR, 1.28; 95% CI, 0.96-1.71), three (IRR, 1.43; 95% CI, 1.04-1.96), and four (IRR, 1.73; 95% CI, 1.26-2.37) were at progressively higher risk. In restricted spline curves, a non-linear association was noted between LEs and HTN risk. Regarding the subcategories of LEs, work-related LEs, personal LEs, and all subcategories of negative LEs were associated with an increased risk of HTN. However, among positive LEs, only the family-related cases were associated with a lower risk of HTN.

Conclusion: LEs had a non-linear association with an increased risk of HTN. Negative LEs were risk factors for HTN incidence, whereas positive LEs reduced the risk of HTN. Thus, the importance of LEs should be highlighted in the development of HTN prevention strategies and initiatives.

Keywords: dose-effect relationship; government employee; hypertension; life events; prospective cohort study.