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Association of workplace and population characteristics with prevalence of hypertension among Brazilian industry workers: a multilevel analysis
  1. Daniele B Vinholes1,
  2. Sérgio L Bassanesi1,
  3. Hilton de Castro Chaves Junior2,
  4. Carlos Alberto Machado3,
  5. Ione M F Melo4,
  6. Flavio Danni Fuchs5,6,
  7. Sandra Costa Fuchs1,5
  1. 1 Postgraduate Studies Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
  2. 2 Departament of Clinical Medicine, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
  3. 3 Department of Cardiology, School of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
  4. 4 Formerly at Unit of Health and Safety of Work, Serviço Social da Indústria (SESI), Brasilia, Brazil
  5. 5 Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
  6. 6 Division of Cardiology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
  1. Correspondence to Dr. Sandra Costa Fuchs; sfuchs{at}


Background Exposure to risk factors for hypertension may be influenced by the characteristics of the workplace, where workers spend most of their daily time.

Objectives To evaluate the association between features of the companies, particularly the presence of facilities to provide meals, and of population characteristics and the prevalence of hypertension, taking into account individual risk factors for hypertension.

Material and methods This multilevel analysis was based on a cross-sectional study with individual and company data from the SESI (Serviço Social da Indústria–Social Service of Industries) study and population-based data from the national census statistics. Workers aged ≥15 years were randomly selected from small (20–99), medium (100–499) and large (≥500 employees) companies per state using multistage sampling. Logistic regression was used to analyse the association between hypertension and individual, workplace and population variables, with odds ratios (ORs; 95% CI) adjusted for three-level variables.

Results 4818 Workers from 157 companies were interviewed and their blood pressure, weight and height were measured. Overall, 77% were men, aged 35.4 ±10.7 years, with 8.7 ±4.1 years of schooling and mostly worked in companies with a staff canteen (66%). Besides individual characteristics—being male, ageing, low schooling, alcohol abuse and higher BMI—a workplace with no staff canteen (OR=1.28; 95% CI 1.08 to 1.52), small companies (OR=1.31; 95% CI 1.07 to 1.60) and living in cities with higher economic inequality (OR=1.47; 95% CI 1.23 to 1.76) were associated with a higher risk for hypertension.

Conclusion Among Brazilian workers, the prevalence of hypertension is associated with individual risk factors, lack of a canteen at the workplace, small companies and higher economic inequalities of cities. These three-level characteristics help to interpret differences in the prevalence of hypertension between regions or countries.

  • workplace
  • employee
  • worker
  • socioeconomic
  • hypertension
  • risk
  • Brazil

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  • Contributors HdCC, CAM, IMFM, FDF, SCF made substantial contributions to conception and design; DBV, FDF, SLB, SCF analysed and interpreted the data; DBV, CAM, HdCC, IMFM helped to draft the manuscript, and DBV, FDF, SLB, SCF reviewed the manuscript critically for important intellectual content. The authors had full access to all of the data in the study and DBV and SCF take responsibility for the contents of the article. All authors gave final approval of the version to be published.

  • Funding The SESI Study was supported and funded by the Pan American Health Organization (PAHO) and the Brazilian Ministry of Health. DBV received a fellowship from Coordination for the Improvement of Higher Education Personnel (CAPES) and SCF received a fellowship from National Counsel of Technological and Scientific Development (CNPq). PAHO, Brazilian Ministry of Health, CAPES, and CNPq played no part in the study design, data analysis, results interpretation or drafting of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Research ethics committee of the Universidade Federal do Rio Grande do Sul.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The additional data report from the study is available to researchers at:

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