Personalized assessment of the risk of hypertension when exposed to noise and vibration

Introduction. The relevance of the study is due to the medical and social significance of the problem of prevention of cardiovascular diseases in workers in harmful and (or) dangerous working conditions. The aim is to develop an algorithm for a personalized assessment of the risk of arterial hypertension (AH) when exposed to noise and vibration. Materials and methods. Two groups were examined: group 1 (four hundred twenty people) consisted of workers of processing plants exposed to noise; group 2 (355 people) – underground miners exposed to combined noise and vibrations. To identify risk factors for hypertension, subgroups are allocated in each group, depending on the presence of hypertension – the “AH+” subgroup and the “AH–” subgroup. Occupational and non-occupational risk factors of hypertension were assessed. For each of the risk factors of hypertension, for which a significant difference was established in the compared subgroups, the prognostic coefficient was calculated using the Wald method of sequential mathematical analysis. Results. A high prevalence of hypertension was found in workers exposed to noise (43%) and combined effects of noise and vibration (47%) with an average degree of occupational conditioning (RR=1.5–1.57, EF=33.0–34.0%). Prognostically significant risk factors for hypertension were identified: the age of an employee over 50 years, work experience under the influence of noise and vibration for more than 20 years, a smoking index of more than 20, a high level of personal anxiety, a violation of carbohydrate metabolism, a state of maladaptation (index of functional changes IFC>3.1), an imbalance of the autonomic nervous system with a predominance of sympathicotonia (LF/HF>1.5). Based on the results obtained, a personalized algorithm for assessing the total risk of hypertension has been developed. Limitations. The data obtained was specific to workers exposed to noise and vibration, the methodological approach of this study can be used to assess the risk of hypertension in workers in other occupational groups. Conclusion. The application of the algorithm will make it possible to identify workers predisposed to hypertension at the early stages of the disease, form groups of dispensary supervision, and carry out preventive measures to prevent the progression of hypertension.