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ERGONOMICS  July 2009

ERGONOMICS July 2009

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Subject:

Masked Hypertension, Cognitive Impairment and Early Retirement due to Ill Health

From:

David McFarlane <[log in to unmask]>

Reply-To:

David McFarlane <[log in to unmask]>

Date:

Tue, 14 Jul 2009 05:46:35 +0100

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (88 lines)

Dear All,

Here is another issue that might possibly be related to psychosocial factors 
and all that jazz. 

Hypertension and mental problems are among the main reasons for early 
retirement due to ill health. Over 50% of older Australians (over 50) who are 
not in the workforce have "mental and behavioral disorders" and over a quarter 
(28%) are known to suffer from hypertension (Schofield et al, 2008).

It is possible that many of those have cognitive impairment due to 
hypertension either because their hypertension is untreated or simply not 
because it has never been diagnosed. A recent study showed that US adults 
over 65 have a significant cognitive advantage over those sampled in the UK; 
the study found that more of those US adults were taking medication for 
hypertension and it appears that this treatment might be associated with their 
better cognitive function (Langa et al, 2009). A survey of the health of 
workers at retirement age in the UK has shown that the prevalence of 
hypertension is an area of concern (Davies and Holdsworth, 1985) hence this 
should logically be dealt with long before their retirement from the workforce. 

Recent research shows that many cases of hypertension are not detected by 
conventional clinical testing. The advent of ambulatory blood pressure 
monitoring for in clinical practice has shown that there is a group of patients 
who are at risk from high blood pressure because they appear to be normal 
("normotensive") by clinic measurement but they are found to be hypertensive 
by ambulatory measurement. This problem has been called "Masked 
Hypertension" or "Undetected Ambulatory Hypertension" (Pickering et al, 2002).

Job stress seemed to be one of the main causes of masked hypertension; 
hence frequent measurements of the blood pressure (BP) at the work place 
should be used to identify subjects with masked hypertension (Yamasue et al, 
2008).

Pre-retirement occupation is risk factors for hypertension among seniors (Leigh 
and Du, 2009); it is commonly thought that managers are at most risk but a 
recent study found that female workers who are professionals, salespeople, 
private household cleaning service workers, and personal service workers are 
more likely than managers to report hypertension. Male workers who are 
salespersons, personal service workers, mechanics, construction trades, 
precisions production workers, and operators are more likely than managers to 
report hypertension. Hence logically measurements of ambulatory BP at the 
work place should be used to identify workers with masked hypertension in 
high-risk occupations such as those. 

Is anyone actually doing this?

Regards,

David McFarlane MAppSc (Ergonomics)
Ergonomist, WorkCover NSW

References

1. D Schofield, R Shrestha, M Passey, A Earnest, S Fletcher, (2008), "Chronic 
disease and labour force participation among older Australians", Med J Aust, 
2008 Oct 20, 189, (8), pp 447-50. See 
http://www.ncbi.nlm.nih.gov/pubmed/18928439 and 
http://www.mja.com.au/public/issues/189_08_201008/sch11012_fm.html

2. K Langa, D Llewellyn, I Lang, D Weir, R Wallace, M Kabeto, F Huppert, 
(2009), "Cognitive health among older adults in the United States and in 
England", BMC Geriatr, 2009 Jun 25, 9, (1), p 23. 
http://www.ncbi.nlm.nih.gov/pubmed/19555494

3. L Davies, M Holdsworth, (1985), "Nutrition and health at retirement age in 
the United Kingdom", Hum Nutr Appl Nutr, 1985 Oct, 39, (5), pp 315-32. 
http://www.ncbi.nlm.nih.gov/pubmed/4077569

4. T Pickering, K Davidson, W Gerin, J Schwartz, (2002), "Masked 
Hypertension", Hypertension, 40, pp 795-796. 
http://hyper.ahajournals.org/cgi/content/full/40/6/795

5. K Yamasue, T Hayashi, K Ohshige, O Tochikubo, T Souma, (2008), "Masked 
hypertension in elderly managerial employees and retirees", Clin Exp Hypertens, 
Apr 2008, 30, (3), pp 203-11. http://www.ncbi.nlm.nih.gov/pubmed/18425700

6. J Leigh, J Du, (2009), "Hypertension and occupation among seniors", J 
Occup Environ Med, 2009 Jun, 51, (6), pp 661-71. 
http://www.ncbi.nlm.nih.gov/pubmed/19415032

Disclaimer

Any recommendation concerning the use or representation of a particular 
brand of product in this document or any mention of them whatsoever 
(whether this appears in the text, illustrations, photographs or in any other 
form) is not to be taken to imply that WorkCover NSW approves or endorses 
the product or the brand.

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