Wendy Miklos

Project title: Occupation and Hypertension Awareness, Washington State Behavioral Risk Factor Surveillance System 2003, 2005, 2007, and 2009

Degree: MPH | Program: Occupational and Environmental Medicine (OEM) | Project type: Thesis/Dissertation
Completed in: 2013 | Faculty advisor: June T. Spector


Background: Hypertension is associated with substantial morbidity and mortality and is a modifiable risk factor for cardiovascular disease and stroke. Many public health efforts are aimed at the prevention and control of hypertension. Few studies have reported on the prevalence of hypertension awareness by occupation using detailed respondent information. PURPOSE: The purpose of this study was to determine whether certain occupational groups of workers in Washington State (WA) are associated with a higher risk of having been diagnosed with hypertension and to describe the workers' levels of occupational and leisure time physical activity by occupational group.

Methods: Using WA Behavioral Risk Factors Surveillance System (BRFSS) survey data for 2003, 2005, 2007, and 2009, we estimated the prevalence of hypertension awareness and the adjusted odds of hypertension awareness by occupational group. We also report the prevalence estimates of levels of occupational and leisure time physical activities by occupational group.

Results: The prevalence of hypertension awareness varied across occupational groups: the highest prevalence was among `transportation and material moving' workers and the lowest prevalence was among `health-diagnosing' occupations. The adjusted odds of hypertension awareness were similar or higher for many of the occupational groups when compared to the referent group, `executive, administrative, and managerial' occupations. While no occupational group demonstrated statistically significantly higher odds of hypertension awareness, three groups demonstrated statistically significantly lower odds: `mathematical and computer scientists' [adjusted odds ratio 0.63; 95% CI (0.44 to 0.90)], `construction and construction trade' workers [adjusted odds ratio 0.64; 95% CI (0.49 to 0.85)], and the broad group of `librarians, archivists, curators, social recreation, religious workers, writers, artists, entertainers and athletes' [adjusted odds ratio 0.72; 95% CI (0.57 to 0.90)]. Nearly two-thirds of occupational groups indicated sedentary occupational physical activity, and nearly one-half of occupational groups indicated sedentary leisure time physical activity.

Conclusion: Our findings indicate that occupation has important associations with hypertension awareness. Certain occupational groups, identified to be at risk for hypertension, may benefit from employee blood pressure screening programs and early detection of hypertension. Hypertension control programs could improve strategies to help reduce stressors at work and increase physical activity to healthy levels. Public health entities may need more rigorous campaign efforts to emphasize the importance of healthy levels of leisure time physical activity.