Work-Family Conflict and Ideal Cardiovascular Health Score in the ELSA-Brasil Baseline Assessment.

Background There are few data about the association between work-related stress and the American Heart Association ideal cardiovascular health (CVH) metrics. We studied the association between work-family conflict (WFC) and ideal CVH scores in the ELSA-Brasil (Brazilian Longitudinal Study of Adult Health) baseline study. Methods and Results We analyzed data of active workers (5424 men and 5967 women), aged 35 to 74 years, from 2008 to 2010. Ideal CVH scores were calculated based on the lifestyle and health metrics proposed by the American Heart Association, using data from questionnaires and clinical and laboratory examinations from the ELSA-Brasil study baseline. The WFC questionnaire was based on the Frone model, validated for Brazilian Portuguese. WFC domains (time and strain-based work interference with family, family interference with work, and lack of time for personal care and leisure) and frequency (never to rarely, sometimes, or frequently) were self-reported. Main models were adjusted for age, sex, race, educational level, income, and study site. Positive relative predicted score differences (rPSDs) indicate higher predicted scores. We found lower lifestyle ideal CVH scores among men (rPSD, -5.7%; P=0.002) and women (rPSD, -10.2%; P<0.001) with frequent lack of time for personal care and leisure. We found lower lifestyle ideal CVH scores among women with frequent strain-based work interference with family (rPSD, -5.1%; P=0.002), and family interference with work (rPSD, -8.6%; P=0.001). We found higher health ideal CVH scores among men with frequent WFC, which may be attributable to reverse causation. Conclusions We found significant associations between WFC and ideal CVH scores. These associations were heterogeneous according to sex.

Job Strain and Cardiovascular Health Score (from the Brazilian Longitudinal Study of Adult Health [ELSA-Brasil] Baseline).

We aimed to study the association between the American Heart Association cardiovascular health (CVH) score and job strain in the Brazilian Longitudinal Study of Adult Health baseline. We analyzed data from 11,351 active workers (aged 35 to 74 years) without overt cardiovascular disease and who had complete data. Job strain was assessed using the 17-item Brazilian version of the Swedish Job Demand-Control-Support Questionnaire. Clinical (fasting plasma glucose, total cholesterol, and blood pressure) and lifestyle (diet, physical activity, smoking, and body mass index) components of CVH score were assessed according to the American Heart Association criteria. We used quasi-Poisson and multinomial regression models, adjusted for age, gender, race, educational level and income, and positive relative predicted score differences (rPSDs) indicate greater predicted scores. Subjects with low skill discretion scores had lower global (rPSD: -1.8%; p = 0.021) and lifestyle (rPSD: -3.6%; p = 0.018) CVH scores. Participants with low decision authority (rPSD: -2.4%; p = 0.029) and low social support scores (rPSD: -3.3%; p = 0.001) also had lower lifestyle CVH scores. In conclusion, we found significant associations between job strain and CVH scores in this large multicenter sample.