ABC | Volume 112, Nº3, March 2019

Original Article Muniz et al Ideal cardiovascular health and job strain Arq Bras Cardiol. 2019; 112(3):260-268 CV health. High job strain was associated with a poor diet and obesity. These findings highlight the influence of workplace condition in CV health of employees and the need to implement policies to improve their health. We found no individuals in our sample that would be classified as having ideal CV health as defined by the AHA guideline. More than 90% were classified as having poor CV health. Surprisingly, these findings are worse than those from studies in developed countries. In a United States community‑based study with 1933 individuals, only one individual fulfilled criteria for ideal CV health. In the same study, 17% had intermediate CV health, and 83% had poor CV health. 11 We would expect a better CV health profile in our population since we recruited employees from an academic center with wide access to health information, particularly given the presence of nutrition, medicine and other health‑related disciplines on campus. Furthermore, our sampled population was approximately 10 years younger than the population of other similar studies. 11,12 In an Asian study, the prevalence of ideal CV health was 0.2%, intermediate 21% and poor 79% among hospital workers. 13 Comparing this sample with the current study participants, the main difference of CV parameters can be explained by better blood pressure control and low index of overweight and obesity in the Asian population. Importantly, this worse scenario found in our sample could not be explained by differences in methodology among studies because we used similar definitions for CV health factors as defined by the AHA. 4 In regards to the difference in job strain and CV health, no relationship between job strain and poor CV health was demonstrated. Previous studios with larger sample size than our study demonstrated that job strain was associated with CV health scores or established CV disease. 14 The current study included 451 participants which limits the power to find small differences. Moreover, socio-cultural differences between this study sample and other studies mainly from developing Figure 1 – Stacked bars showing the prevalence of cardiovascular risk factors. BMI: Body mass index (kg/m 2 ). 100 80 60 40 20 0 Physical Activity BMI Hypertension Diabetes Diet Smoking Cholesterol Percentage 23 25 26 53 55 19 35 43 22 22 71 7 11 53 36 74 26 7 93 Poor Intermediate Ideal Table 2 – Distribution (count) of poor cardiovascular health factors according to job strain* Number of poor CV factors Low strain n = 144(32%) Active n = 93(21%) Passive n = 128(28%) High Strain n = 86(19%) 0 16 (11) 9 (10) 12 (9) 6 (7) 1 52 (36) 31 (33) 27 (21) 18 (21) 2 37 (26) 23 (25) 35 27) 27 (31) 3 29 (20) 17 (18) 35 (27) 25 (29) 4 5 (4) 9 (10) 13 (10) 8 (9) 5 3 (2) 4 (4) 4 (3) 2 (2) 6 2 (1) 0 2 (2) 0 7 0 0 0 0 Mean of poor CV factors (n) 1.8 2 2.2 2.2 p >0.05 for all group comparisons. CV: cardiovascular. 263