Vol 67, No 4 (2016)
Original article
Published online: 2016-12-23

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Hypertension among Danish seafarers

Mingshan Tu, Jorgen Riis Jepsen
Pubmed: 28009392
IMH 2016;67(4):196-204.

Abstract

Background: Due to the high prevalence of arterial hypertension and its role in the development of atherosclerosis, myocardial infarction and stroke, hypertension is a major public health challenge worldwide. There is limited knowledge of the prevalence of hypertension among seafarers who, however, are known to have an excess morbidity and mortality from these disorders. This article addresses the prevalence of hypertension among Danish seafarers and discusses potential risk factors for hypertension in maritime settings.

Materials and methods: A representative sample of 629 Danish seafarers who had statutory medical examinations was studied from the beginning of October 2011 to the end of June 2012. The medical examination included measurements of blood pressure. The prevalence of hypertension in the study population was stratified by age, work place on board, smoking status, alcohol intake, and body mass index.

Results: The overall prevalence of hypertension in the study population was 44.7% (95% CI 40.8–48.6). In a comparison sample of adult Danes, the crude rate of hypertension was 12.6%. In addition, 41.8% (95% CI 38.0–45.7) of seafarers were pre-hypertensive. Hypertension was particularly increased among younger seafarers. The proportion of seafarers in antihypertensive treatment was low, in particular among the young seafarers.

Conclusions: Hypertension is a major health issue among Danish seafarers. In addition to ensuring antihypertensive treatment when needed, individual and collective prevention should address lifestyle issues as well as physical and psychosocial exposures at sea.

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References

  1. Ezzati M, Lopez AD, Rodgers A, et al. Comparative Risk Assessment Collaborating Group. Selected major risk factors and global and regional burden of disease. Lancet. 2002; 360(9343): 1347–1360.
  2. Prevention, detection, evaluation, and treatment of hypertension. The Sixth Report of the Joint National Committee. National Institutes of Health-National Heart, Lung, and Blood Institute. National High Blood Pressure Education Programme. Indian Heart J. 1999; 51(4): 381–396.
  3. Raised blood pressure: World Health Organization 2016. http://www.who.int/gho/ncd/risk_factors/ blood_pressure_prevalence_text/en/ (25.06.2016).
  4. Turnbull F. Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet. 2003; 362(9395): 1527–1535.
  5. Herttua K, Martikainen P, Batty GD, et al. Poor Adherence to Statin and Antihypertensive Therapies as Risk Factors for Fatal Stroke. J Am Coll Cardiol. 2016; 67(13): 1507–1515.
  6. Kronborg CN, Hallas J, Jacobsen IbA. Prevalence, awareness, and control of arterial hypertension in Denmark. J Am Soc Hypertens. 2009; 3(1): 19–24.
  7. Oldenburg M. Risk of cardiovascular diseases in seafarers. International Maritime Health. 2014; 65(2): 53–57.
  8. Møller Pedersen SF, Jepsen JR. The metabolic syndrome among Danish seafarers. Int Marit Health. 2013; 64(4): 183–190.
  9. Hansen HL, Hjarnoe L, Jepsen JR. Obesity continues to be a major health risk for Danish seafarers and fishermen. Int Marit Health. 2011; 62(2): 98–103.
  10. Romero-Paredes M, Reinoso-Barbero L, González-Gómez M, et al. Improving cardiovascular health in Spanish seafarers. International Maritime Health. 2016; 67(1): 3–8.
  11. Romero-Paredes Md, Reinoso-Barbero L, González-Gómez MF, et al. Improving cardiovascular health in Spanish seafarers. Int Marit Health. 2016; 67(1): 3–8.
  12. Sehestedt T, Ibsen H, Jørgensen T. Awareness, treatment and control of hypertension in Denmark. The Inter99 study. Blood Press. 2007; 16(5): 312–319.
  13. Rosik E, Jaremin B, Szymańska K. Can general cardiovascular risk evaluation facilitate the assessment of fitness for work and contribute to the reduction of cardiovascular incidents among seamen and fishermen? Article for discussion. Int Marit Health. 2006; 57(1-4): 188–197.
  14. Poulsen TR, Burr H, Hansen HL, et al. Health of Danish seafarers and fishermen 1970-2010: What have register-based studies found? Scand J Public Health. 2014; 42(6): 534–545.
  15. Jaremin B, Kotulak E. Myocardial infarction (MI) at the work-site among Polish seafarers. The risk and the impact of occupational factors. Int Marit Health. 2003; 54(1-4): 26–39.
  16. Roberts SE. Mortality from disease among seafarers in British merchant shipping (1976-1995). Int Marit Health. 2002; 53(1-4): 43–58.
  17. Hansen HL. Surveillance of deaths on board Danish merchant ships, 1986-93: implications for prevention. Occup Environ Med. 1996; 53(4): 269–275.
  18. Borch DF, Hansen HL, Burr H, et al. Surveillance of maritime deaths on board Danish merchant ships, 1986-2009. Int Marit Health. 2012; 63(1): 7–16.
  19. Roberts SE, Hansen HL. An analysis of the causes of mortality among seafarers in the British merchant fleet (1986-1995) and recommendations for their reduction. Occup Med (Lond). 2002; 52(4): 195–202.
  20. Order of medical examinations of seafarers and fishermen, Copenhagen: Danish Maritime Authority. http://www.dma.dk/sitecollectiondocuments/legislation/orders/2013/bek-999-12082013-laegeundersoegelse af soefarende.pdf. (26.06.2016).
  21. Understanding Blood Pressure Readings: American Heart Association; 2014. http://www.heart. org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Understanding-Blood-Pressure-Readings_UCM_301764_ Article.jsp (25.06.2016).
  22. Guidelines on the medical examination of seafarers, London: International Maritime Organization; 2013 . http://www.safety4sea.com/images/media/pdf/IMO-Guidelines_on_the_Medical_Examination_of_the_Seafarers.pdf (25.06.2016).
  23. Oldenburg M, Baur X, Schlaich C. Cardiovascular diseases in modern maritime industry. Int Marit Health. 2010; 62(3): 101–106.
  24. Oldenburg M, Harth V, Jensen HJ. Overview and prospect: food and nutrition of seafarers on merchant ships. Int Marit Health. 2013; 64(4): 191–194.
  25. Sunde E, Irgens-Hansen K, Moen BE, et al. Noise and exposure of personnel aboard vessels in the Royal Norwegian Navy. Ann Occup Hyg. 2015; 59(2): 182–199.
  26. Jepsen JR, Zhao Z, van Leeuwen WMA. Seafarer fatigue: a review of risk factors, consequences for seafarers' health and safety and options for mitigation. Int Marit Health. 2015; 66(2): 106–117.
  27. Jezewska M, Babicz-Zielińska E, Leszczyńska I, et al. Promotion of healthy nutrition of seafarers. Int Marit Health. 2009; 60(1-2): 48–50.
  28. Poorolajal J, Farbakhsh F, Mahjub H, et al. How much excess body weight, blood sugar, or age can double the risk of hypertension? Public Health. 2016; 133: 14–18.
  29. Tremblay MS, Colley RC, Saunders TJ, et al. Physiological and health implications of a sedentary lifestyle. Appl Physiol Nutr Metab. 2010; 35(6): 725–740.
  30. Beunza JJ, Martínez-González MA, Ebrahim S, et al. Sedentary behaviors and the risk of incident hypertension: the SUN Cohort. Am J Hypertens. 2007; 20(11): 1156–1162.
  31. Barton J, Folkard S, Smith L, et al. Effects on health of a change from a delaying to an advancing shift system. Occup Environ Med. 1994; 51(11): 749–755.
  32. Su TC, Lin LY, Baker D, et al. Elevated blood pressure, decreased heart rate variability and incomplete blood pressure recovery after a 12-hour night shift work. J Occup Health. 2008; 50(5): 380–386.
  33. Jarup L, Babisch W, Houthuijs D, et al. HYENA study team. Hypertension and exposure to noise near airports: the HYENA study. Environ Health Perspect. 2008; 116(3): 329–333.
  34. van Kempen E, Babisch W. The quantitative relationship between road traffic noise and hypertension: a meta-analysis. J Hypertens. 2012; 30(6): 1075–1086.
  35. de Souza TC, Périssé AR, Moura M. Noise exposure and hypertension: investigation of a silent relationship. BMC Public Health. 2015; 15: 328.
  36. Maritime Safety Committee agrees new measures for passenger ship safety and protection of personnel from noise on-board ships 2012.
  37. Night Noise Guidelines for Europe, Bonn: World Health Organization; 2007. http://ec.europa.eu/ health/ph_projects/2003/action3/docs/2003_08_frep_en.pdf (25.06.2016).
  38. Calhoun DA, Harding SM. Sleep and hypertension. Chest. 2010; 138(2): 434–443.
  39. Pickering TG, Hall JE, Appel LJ, et al. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Circulation. 2005; 111(5): 697–716.
  40. How to Monitor and Record Your Blood Pressure: American Heart Association; 2014. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/ SymptomsDiagnosisMonitoringofHighBloodPressure/How-to-Monitor-and-Record-Your-Blood-Pressure_UCM_303323_Article.jsp - .V5YWzI78S3N (25.06.2016).
  41. Bakx C, Oerlemans G, van den Hoogen H, et al. The influence of cuff size on blood pressure measurement. J Hum Hypertens. 1997; 11(7): 439–445.
  42. Gómez-Marín O, Prineas RJ, Råstam L. Cuff bladder width and blood pressure measurement in children and adolescents. J Hypertens. 1992; 10(10): 1235–1241.
  43. Jones DW, Appel LJ, Sheps SG, et al. Measuring blood pressure accurately: new and persistent challenges. JAMA. 2003; 289(8): 1027–1030.
  44. O'Brien E, Beevers G, Lip GY. ABC of hypertension: Blood pressure measurement. Part IV-automated sphygmomanometry: self blood pressure measurement. BMJ. 2001; 322(7295): 1167–1170.