Women, employment status, and hypertension: Cross-sectional and prospective findings from the Atherosclerosis Risk in Communities (ARIC) Study

PURPOSE: This study examined the cross-sectional and prospective associatio ns between employment status and hypertension among middle-aged, African-Am erican (AA) and European-American (EA) women participating in the Atheroscl erosis Risk in Communities Study. METHODS: Employed women and homemakers from the baseline examination (1987- 89) were included in the cross-sectional study (n = 7351). Associations bet ween employment and the incidence of hypertension ascertained at visit 2 (1 990-92) were determined among! those who at baseline, had low-normal blood pressure (not hypertensive and systolic blood pressure (SBP) less than or e qual to 120 mm l-ig systolic and diastolic blood pressure (DBP) less than o r equal to 80 mm Hg (n = 3194). Logistic regression analysis was used to ex amine the association between employment status and hypertension by ethnici ty, taking into account covariates. RESULTS: At baseline, employed women were less likely to be hypertensive (S BP greater than or equal to 140 mm Hg or DBP greater than or equal to 90 mm Hg or current use of antihypertensive drugs) than were homemakers (prc val ence odds ratio (POR) = 0.70; 95% confidence interval (CI) = 0.62-0.79), co ntrolling for age, body mass index, and education. Among the subgroup who h ad low normal blood pressure at baseline, employed women were less likely t o develop hypertension during the three-year time period than were homemake rs (odds ratio (OR) = 0.68; 95% CI = 0.44-1.05). The inverse association wa s stronger among AA (RR = 0.37; 95% CI = 0.16-0.88) than EA (OR = 0.83; 95% CI = 0.50-1.38) women. CONCLUSIONS: These findings suggest that the inverse association between hy pertension and employment status is not due to a healthy worker effect, and that employment may confer protection against incident hypertension in wom en. (C) 1999 Elsevier Science Inc. All rights reserved.