All ETDs from UAB

Advisory Committee Chair

Kathleen C Brown

Advisory Committee Members

Karen L Heaton

Elizabeth H Maples

James M Lance

Jennan A Phillips

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Nursing


Although hypertension is highly prevalent, associated with serious health consequences and treatable, fewer than half of those with hypertension have achieved blood pressure control (Centers for Disease Control and Prevention [CDC], 2011b). Limited studies have examined the influence of perceived stress, job satisfaction, life satisfaction, and perceived health status may have on blood pressure control, although epidemiological evidence reveals psychological factors can mediate and negatively influence health behavior leading to hypertension (Blanchflower & Oswald, 2008; Kulkarni, Farrel, Erasi, & Kochar, 1998; Walcott-McQuigg, 2000). The purpose of this study was to explore the prevalence of hypertension, obesity, and blood pressure control and examine the influence of perceived stress, job satisfaction, life satisfaction, perceived health status, department, type of shift worked and personal factors (gender, race, age, obesity, abdominal adiposity, tobacco use, salt intake, and physical activity) on blood pressure control among 3,501 municipal workers in a large city in the southeastern U.S. A secondary analysis of cross-sectional data collected during the municipality's 2010-2011 regularly scheduled wellness program was used to achieve the aims of the study. Associations were examined using multinomial logistic regression. Sixty eight percent of the 1,577 workers with hypertension were obese. Furthermore, in females with hypertension, abdominal adiposity was particularly prevalent (n = 350, 83.7%). Using a backwards selection model of logistic regression and a p-to-stay criteria of 0.1, principal predictors of blood pressure control in this study were age (p < .001), gender (p = < .001), perceived stress (p = .061), tobacco abstinence (p = .008), and department (p < .001). Individuals with uncontrolled blood pressure reported the lowest levels of stress, a key finding which may suggest that the impact of perceived stress on blood pressure con-trol could be mediated by individual differences in reactions to stress. Additionally, workers with high levels of perceived health had fewer maladaptive health behaviors such as eating salty foods every day, using tobacco, and infrequent physical activity. Further studies are needed to explore relationships among stress, age, gender, and tobacco use, and the control of hypertension in other occupational groups.

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Nursing Commons



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