Hypertension is not the link between job strain and coronary heart disease in the Whitehall II study.
نویسندگان
چکیده
BACKGROUND Hypertension is assumed to be one of the mechanisms through which job strain (a combination of high work demands and low job control) increases coronary heart-disease risk. However, direct tests of this hypothesis are lacking. METHODS We examined whether hypertension mediated the association between job strain and incident coronary heart disease among 5630 men and 2456 women free of coronary heart disease at study entry. Job strain was assessed at phase 1 (1985 to 1988); hypertension and systolic and diastolic blood pressure (BP) were assessed at phases 1, 3 (1992 to 1993), and 5 (1997 to 1999); and incident coronary heart disease was assessed from the end of phase 1 to phase 7 (2003 to 2004) (698 events; median follow-up, 16.1 years). RESULTS After adjustment for age, sex, ethnicity, and employment grade, job strain was associated with an increased incidence of coronary heart disease. Further adjustments, for hypertension, systolic BP, and diastolic BP at phase 1 and across phases 1, 3, and 5, and the slope of hypertension and BP over time, had little effect on this association, although measures of hypertension and BP were strongly related to incident coronary heart disease. CONCLUSIONS Data, including repeated casual measurements of hypertension and BP, suggest that the development of chronic hypertension is not a key mechanism linking job strain and coronary heart disease. Further research on ambulatory measurements is needed to determine whether episodic BP elevations have a role in this association.
منابع مشابه
Effect of Stress on Coronary Risk Factors
In India, a survey indicates the prevalence of 30 times increase in hypertension among urban dwellers, compared with 10 times in rural inhabitants.1 Urbanization together with a change in life style, diet, and job stress, has been attributed in causing hypertension.Stress can cause hypertension by elevating the blood pressure (BP) and by stimulating the nervous system leading to the production ...
متن کاملJob strain, job demands, decision latitude, and risk of coronary heart disease within the Whitehall II study.
STUDY OBJECTIVES To investigate the association between job strain and components of the job strain model and coronary heart disease (CHD) risk. DESIGN Prospective cohort study (Whitehall II study). At the first phase of the study (1985-1988), data on self reported psychosocial work characteristics were collected from all participants. Participants were followed up until the end of phase 5 (1...
متن کاملThe influence of low job control on ambulatory blood pressure and perceived stress over the working day in men and women from the Whitehall II cohort.
OBJECTIVE Work stress contributes to risk of coronary heart disease and hypertension. This study tested the influence of job control on ambulatory blood pressure, and ratings of perceived stress and happiness in men and women systematically sampled by socio-economic status from the Whitehall II epidemiological cohort. PARTICIPANTS A total of 227 men and women aged 47-59 years sampled from hig...
متن کاملUnfairness and health: evidence from the Whitehall II Study.
OBJECTIVE To examine the effects of unfairness on incident coronary events and health functioning. DESIGN Prospective cohort study. Unfairness, sociodemographics, established coronary risk factors (high serum cholesterol, hypertension, obesity, exercise, smoking and alcohol consumption) and other psychosocial work characteristics (job strain, effort-reward imbalance and organisational justice...
متن کاملStudy of the correlation between ACE gene polymorphism and coronary artery disease
Introduction: Angiotensin converting enzyme (ACE) is an exopeptidase that converts Angiotensin I to Angiotensin II. Angiotensin II is a potent vasoconstrictor and releases aldosterone, and have a critical role in hypertension. In this study, ACE insertion / deletion (I/D) polymorphism and ACE activity was determined in patients with coronary artery disease (CAD) and normal subjects. The corr...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- American journal of hypertension
دوره 20 11 شماره
صفحات -
تاریخ انتشار 2007