A cohort study on the association between changing occupational stress, hair cortisol concentration, and hypertension

Jin Wang; Lejia Zhu; Lin Song; Ziqi Zhou; Weiling Chan; Geyang Li; Li Zhou; Jing Xiao; Yulong Lian

doi:10.1371/journal.pone.0285623

A cohort study on the association between changing occupational stress, hair cortisol concentration, and hypertension

PLoS One. 2023 May 17;18(5):e0285623. doi: 10.1371/journal.pone.0285623. eCollection 2023.

Authors

Jin Wang¹, Lejia Zhu¹, Lin Song¹, Ziqi Zhou¹, Weiling Chan¹, Geyang Li¹, Li Zhou¹, Jing Xiao², Yulong Lian¹

Affiliations

¹ Division of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China.
² Department of Occupational Environmental Toxicology, School of Public Health, Nantong University, Nantong, Jiangsu, China.

Abstract

Objective: To explore the relationship between changing occupational stress levels, hair cortisol concentration (HCC), and hypertension.

Methods: Baseline blood pressure of 2520 workers was measured in 2015. The Occupational Stress Inventory-Revised Edition (OSI-R) was used to assess changes in occupational stress. Occupational stress and blood pressure were followed up annually from January 2016 to December 2017. The final cohort numbered 1784 workers. The mean age of the cohort was 37.77±7.53 years and the percentage male was 46.52%. At baseline, 423 eligible subjects were randomly selected for hair sample collection to determine cortisol levels.

Results: Increased occupational stress was a risk factor for hypertension [risk ratio (RR) = 4.200, 95% confidence interval (CI): 1.734-10.172]. The HCC of workers with elevated occupational stress was higher than that of workers with constant occupational stress [(ORQ score ≥70: geometric mean±geometric standard deviation = 5.25±3.59 ng/g hair; 60-90: 5.02±4.00; 40-59: 3.45±3.41; <40: 2.73±3.40) x2 = 5.261]. High HCC increased the risk of hypertension (RR = 5.270, 95% CI: 2.375-11.692) and high HCC was associated with higher rates of elevated diastolic and systolic blood pressure. The mediating effect of HCC was 0.51[(95% CI: 0.23-0.79, odds ratio(OR) = 1.67] and accounted for 36.83% of the total effect.

Conclusions: Increased occupational stress could lead to an increase in hypertension incidence. High HCC could increase the risk of hypertension. HCC acts as a mediator between occupational stress and hypertension.

Copyright: © 2023 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adrenocortical Hyperfunction*
Adult
Cohort Studies
Hair
Humans
Hydrocortisone
Hypertension* / epidemiology
Hypertension* / etiology
Male
Middle Aged
Occupational Stress* / complications
Stress, Psychological / complications

Substances

Hydrocortisone

Grants and funding

This work was supported by the Natural Science Foundation of Jiangsu Province, China (Grant Number: BK20171256、BK2021020829); Qinglan Project of Jiangsu Province of China. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. There was no additional external funding received for this study.