Masked hypertension in air traffic controllers at work

Objective. To study the features of changes in hemodynamic parameters in the air traffic controllers at work and the rate of “masked” hypertension.

Design and methods. We examined 55 air traffic controllers from Moscow Centre for Automated Air Traffic Management of the Federal State Unitary Enterprise “State Corporation for Air Traffic Management” and 30 information security specialists who formed the comparison group. The groups were comparable by age, work experience (by the specialty), and the level of office blood pressure (BP). We assessed the main cardiovascular risk factors, and blood pressure parameters by 24-hour ambulatory blood pressure monitoring (ABPM).

Results. Despite comparable rates of cardiovascular risk factors, the air traffic controllers demonstrate higher BP levels and higher rates of masked hypertension. According to 24-hour ABPM masked hypertension was detected in 40 % air traffic controllers, which is twice higher than in the comparison group. In addition, the air traffic controllers show significant difference in BP levels in working days and daysoff.

Conclusions. The high rate of masked hypertension among air traffic controllers might be associated with the peculiarities of professional activity, namely, with the high stress level.

1. Boytsov SA, Chuchalin AG, Arutyunov PG, Bilichenko TN, Bubnova MG, Ipatov PV et al. Prevention of chronic non-communicable diseases. Guidelines. M., 2013; 136. In Russian.

2. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Car-diovascular disease. Prevention in Clinical Practice. Eur Heart J. 2016;37(29):23152381. doi.org/10.1093/eurheartj/ehw106

3. Muromtseva GA, Kontsevaya AV, Konstantinov VV, Artamonova GV, Gatagonova TM, Duplyakov DV et al. The prevalence of non-infectious diseases risk factors in Russian population in 2012-2013 years. Results of ECVD-RF. Cardiovasc Ther Prev. 2014;13(6):4-11. doi:10.15829/1728-8800-2014-6-411. In Russian.

4. Anstey DE, Pugliese D, Abdalla M, Bello NA, Givens R, Shimbo D. An update on masked hypertension. Curr Hypertens Rep. 2017;19(12):94. doi:10.1007/s11906-017-0792-4

5. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M et al. 2013 ESH/ESC Practice Guidelines for the management of arterial hypertension. Blood Press. 2014;23(1):3-16. doi:10.3109/08037051.2014.868629.

6. Konstantopoulou AS, Konstantopoulou PS, Papargyriou IK, Liatis ST, Stergiou GS, Papadogiannis DE. Masked, white coat and sustained hypertension: comparison of target organ damage and psychometric parameters. J Human Hypertens. 2010;24(3): 151-157. doi:10.1038/jhh.2009.55

7. Wang YC, Shimbo D, Muntner P, Moran A, Krakoff LR, Schwartz JE. Prevalence of masked hypertension among us adults with nonelevated clinic blood pressure. Am J Epidemiol. 2017;185(3):194-202. doi:10.1093/aje/kww237

8. Cardiovascular prevention 2017. National guidelines. Russian Journal of Cardiology. 2018;(6):7-122. doi:10.15829/1560-40712018-6-7-122.In Russian.

9. Banegas JR, Ruilope LM, de la Sierra A, de la Cruz JJ, Gorostidi M, Segura J et al. High prevalence of masked uncontrolled hypertension in people with treated hypertension. Eur Heart J. 2014;35(46):3304-3312. doi:10.1093/eurheartj/ehu016

10. Franklin SS, O’Brien E, Staessen JA. Masked hypertension: understanding its complexity. Eur Heart J. 2017;38(15):1112-1118. doi:10.1093/eurheartj/ehw502

11. Smirnova MI, Platonova EM, Britov AN, Gorbunov VN, Deev AV, Koshelyaevskaya YaN et al. The rate and characters of masked arterial hypertension and masked ineffectiveness of hypertension treatment in industrial workers according to the preventive examination. Rat Pharmacother Cardiol. 2014;10(5):481-487. doi:10.20996/18196446-2014-10-5-481-487. In Russian.

12. Landsbergis PA, Travis A, Schnall PL. Working conditions and masked hypertension. High Blood Press Cardiovasc Prev. 2013;20(2):69-76. doi:10.1007/s40292-013-0015-2

13. Shevchenko OP, Praskurnichiy EA. Stress-induced arterial hyper-tension. M.: Reafarm, 2004. 144 p. In Russian.

14. Guide to aviation medicine. Ed. by NA Razsolov. M: Ekon-Inform, 2006. 590 p. In Russian.

15. Kenny I, Saeed S, Gerdts E, Midtb0 H, Halland H, L0nnebakken MT. Masked hypertension in obesity: potential predictors and arterial damage. Blood Press Monit. 2017;22(1):12-17. doi:10.1097/MBP.0000000000000220

16. Trudel X, Milot A, Brisson C. Persistence and progression of masked hypertension: A 5-Year Prospective Study. Int J Hypertens. 2013(4):12-17. doi:10.1155/2013/836387

17. Ereminas D. An observational workplace study of cardiovascular variables in air traffic controllers. Aviation. 2009;13(2):50-55. doi:10.3846/1648-7788.2009.13.50-55

18. Costa G. Working and health conditions of Italian air traffic controllers. Int J Occup Saf Ergon. 2000;6(3):365-382. doi:10.1080/10803548.2000.11076461