Blood Pressure Variability and ABPM in Industrial Employees: a Cohort Study

The evaluation of arterial hypertension in workplaces is an important prevention act and a public health priority; few epidemiological study, up to date, has been projected to detect correlation between workplaces and hypertension disease. We studied a cohort of industrial employees(mainly engineering area) to evaluate epidemiological disease data and to study particular aspects of disease; this work focalized to the role of blood pressure variability in workplace and its measurement by Ambulatory blood pressure in 24 hours (ABPM), useful instrument to predict and help to evaluate cardiovascular risk in workers exposed to several agents. In our study underwent ABPM 56 patients referred to an occupational physician; all of these patients were employed in industrial area (mainly engineering district). Identified risk factors: noise (85 dBA), handling of loads (Niosh Index > 1,6), inorganic powders. Job Content Questionnaire (JCQ)was administered to the entire study population, in order to identify the highest risk behavior profiles work related stress. The analysis performed showed no statistically significant correlation. The monitoring was carried out on patients with the indications provided by the ESH-ESC 2007 guidelines for the treatment of hypertension. The data analysis has highlighted the correlation between profile and BP circadian variability, in particular the SBP and MAP, calculated by evaluating the standard deviations; data also have shown that SBP and MAP variability within 24-hour and circadian profiles are two mutually independent variables and not correlated. The dipper group, which preserves a physiological circadian rhythm and is therefore considered a lower risk of cardio-cerebrovascular accidents, has a higher pressure variability compared to other groups, therefore an additional factor of cardiovascular risk. Exposure to noise, and high cardiometabolic request due to handling of loads (with a METs estimated to 3-4), may be contributing cause of these peculiar aspects of disease in our study cohort. Further studies are needed to confirm the observations made so far, in terms of examined population follow-up that we propose to make in the coming years. All these information should be considered in occupational medicine, especially in cardiometabolic risk management of industrial workers.