This article is more than 5 years old. Information may no longer be current.
Women with hypertension, physically demanding jobs at elevated risk for ischemic heart disease
Click Here to Manage Email Alerts
Female nurses with hypertension and high physical activity at work are at increased risk for ischemic heart disease, according to findings published in the European Journal of Preventive Cardiology.
Researchers analyzed 12,093 female nurses from the Danish Nurse Cohort Study aged 45 to 64 years at baseline in 1993. At baseline, the nurses provided information on physical activity of work, hypertension history, risk factors for ischemic heart disease and other factors related to their occupation. They were followed through 2008 and the researchers obtained information on incident ischemic heart disease from the National Register of Hospital Discharges.
Karen Allesøe
“Previous research has shown that men and women with physically demanding jobs have an increased risk of heart disease,” Karen Allesøe, a PhD student in the department of sports science and clinical biomechanics, University of Southern Denmark, said in a press release. “Lifting and carrying can cause a rise in [BP] and may put people with hypertension at particular risk of a [CV] event. We wanted to investigate whether women with hypertension and physically demanding jobs have an especially high risk of heart disease.”
When the researchers constructed a fully adjusted model, they determined that compared with nurses with normal BP and moderate physical activity at work, nurses with hypertension and high physical activity at work had a nearly threefold risk for ischemic heart disease (HR = 2.87; 95% CI, 2.12-3.87).
Relative excess risk due to additive interaction was 1.2 (95% CI, 0.26-2.14), they wrote.
Although nurses with normal BP and high physical activity at work had a minor increased risk for ischemic heart disease, the association disappeared after adjustment for smoking and other CV risk factors, Allesøe and colleagues found.
Compared with nurses with normal BP and moderate work physical activity, nurses with hypertension and high work physical activity had 60 (95% CI, 38.1-81.9) extra cases of ischemic heart disease per 10,000 person-years, according to the researchers. Approximately two-thirds of the difference could be explained by additive interaction (40.7; 95% CI, 11.7-69.7), they wrote.
“The two risk factors appear to work together, resulting in an even greater incidence of heart disease,” Allesøe said in the release. “It means hypertensive women with physically demanding work may be especially at risk of heart disease. To our knowledge, this has not been shown before among women. We need more information on which aspects of physically demanding work are harmful.” – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.
Perspective
Back to TopCarl (Chip) Lavie , MD, FACC
These findings are surprising, since typically physical activity reduces cardiac events. It is hard to know significance without knowing their other risk factors, hypertension control, total physical activity, fitness level, etc, which are flaws of this paper.
What women with hypertension can do to reduce their risk for ischemic heart disease includes regular exercise training and having a good level of fitness, having BP well controlled — probably to 120 mm Hg/80 mm Hg with proven medications such as diuretics, ACE inhibitors/angiotensin receptor blockers and calcium channel blockers — and treating lipids to good LDL levels, at least under 100 mg/dL.
Based on this paper, there is no reason for women with hypertension to be cautioned against working jobs with high physical activity.
Click Here to Manage Email Alerts