Job strain and autonomic indices of cardiovascular disease risk (original) (raw)
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Job demands, decisional control, and cardiovascular responses.
Journal of …, 2003
The demand-control model for coronary heart disease was tested using ambulatory blood pressure monitoring. Male patrol officers (N ϭ 118) wore ambulatory blood pressure monitors during 1 of their day shifts with readings taken every 30 min. Following each reading, officers completed a questionnaire using a handheld computer. Significant interactions were obtained between job demands and decisional control for heart rate and pressure rate product such that both variables were highest under conditions of high demand and low control. Main effects were obtained for control such that diastolic blood pressure and mean arterial pressure were significantly higher under conditions of low control. These results support the demand-control model and emphasize the importance of psychological control in cardiovascular responses.
International Journal of Occupational Medicine and Environmental Health, 2010
We claim that a new level of studies is needed to answer a series of important questions about the expanding global chronic disease burden for cardiovascular disease (CVD) and for related conditions such as diabetes, metabolic syndrome, and obesity. These require a new study design structure, related to a new level of theory that goes beyond the current single-factor, a-theoretic epidemiological studies. This new platform for the design of large-scale Work/Stress/Disease studies would assess CVD-related disease mechanisms in a more general and dynamic form, based on the use of new tools for measuring autonomic functions in an occupational stress context and a new theory of disease causation. A sample outline is presented for such a study, based on Stress-Disequilibrium Theory (SDT) hypotheses, building on analytic tools developed for the assessment of stress-related exhaustion effects and chronic disease risks from Heart Rate Variability (HRV) research studies. The goal is to assess the associations between social organizational risks, particularly at work, and hypertension, metabolic syndrome, and diabetes II. The study design is multistage, spanning across several levels of disease-related deregulation , and addressing co-morbidity of the conditions themselves. The study design is meant to span across a broad social population at all levels and would probably be multi-site, involving several countries, to yield the larger sample increased power for finding associations for work-physiological effects.
Work-Related Psychosocial Factors and the Development of Ischemic Heart Disease
Cardiology in Review, 2009
The literature on the relationship between work-related psychosocial factors and the development of ischemic heart disease (IHD) was systematically reviewed: 33 articles presented 51 analyses of studies involving male participants, 18 analyses involving female participants, and 8 analyses with both genders. Twenty of the studies originated in the Nordic countries, and the major dimensions of the Demand-Control Model were the focus of 23 articles. A balanced evaluation of the studies indicates moderate evidence that high psychologic demands, lack of social support, and isostrain are risk factors for IHD among men. Studies performed during recent years have not shown evidence for lack of control as a risk factor for IHD. Several studies have shown that job strain is a risk factor, but in the more recent ones, these associations can be fully explained by the association between demands and disease risk. Insufficient evidence was found for a relationship between IHD and effort-reward imbalance, injustice, job insecurity, or long working hours. Studies involving women are too few to draw any conclusion concerning women, work stress, and IHD.
Is job strain a major source of cardiovascular disease risk? 1
2004
1,Portions of this paper were presented in abstracts to the 3rd International Congress on the,Work Environment and Cardiovascular Disease, International Commission on Occupational Health, March 2002, Düsseldorf, Germany, and to the APA NIOSH Congress: Work, Stress and Health, March 2003, Toronto, Canada. 2 Karolinska Institute, Stockholm, Sweden. 3 Institute for Health Promotion and Disease Prevention Research, University of Southern California
Social Science & Medicine, 1998
AbstractÐThe objectives are to examine if the excess risk of myocardial infarction from exposure to job strain is due to interaction between high demands and low control and to analyse what role such an interaction has regarding socioeconomic dierences in risk of myocardial infarction. The material is a population-based case-referent study having incident ®rst events of myocardial infarction as outcome (SHEEP: Stockholm Heart Epidemiology Program). The analysis is restricted to males 45±64 yr of age with a more detailed analysis con®ned to those still working at inclusion. In total, 1047 cases and 1450 referents were included in the analysis. Exposure categories of job strain were formed from self reported questionnaire information. The results show that high demands and low decision latitude interact with a synergy index of 7.5 (95% C.I.: 1.8±30.6) providing empirical support for the core mechanism of the job strain model. Manual workers are more susceptible when exposed to job strain and its components and this increased susceptibility explains about 25±50% of the relative excess risk among manual workers. Low decision latitude may also, as a causal link, explain about 30% of the socioeconomic dierence in risk of myocardial infarction. The distinction between the interaction and the causal link mechanisms identi®es new etiologic questions and intervention alternatives. The speci®c causes of the increased susceptibility among manual workers to job strain and its components seem to be an interesting and important research question. #
Stress Management at the Worksite: Reversal of Symptoms Profile and Cardiovascular Dysregulation
Hypertension, 2006
Work stress may increase cardiovascular risk either indirectly, by inducing unhealthy life styles, or directly, by affecting the autonomic nervous system and arterial pressure. We hypothesized that, before any apparent sign of disease, work-related stress is already accompanied by alterations of RR variability profile and that a simple onsite stress management program based on cognitive restructuring and relaxation training could reduce the level of stress symptoms, revert stress-related autonomic nervous system dysregulation, and lower arterial pressure. We compared 91 white-collar workers, enrolled at a time of work downsizing (hence, in a stress condition), with 79 healthy control subjects. Psychological profiles were assessed by questionnaires and autonomic nervous system regulation by spectral analysis of RR variability. We also tested a simple onsite stress management program (cognitive restructuring and relaxation training) in a subgroup of workers compared with a sham subgroup (sham program). Workers presented an elevated level of stress-related symptoms and an altered variability profile as compared with control subjects (low-frequency component of RR variability was, respectively, 65.2Ϯ2 versus 55.3Ϯ2 normalized units; PϽ0.001; opposite changes were observed for the high-frequency component). These alterations were largely reverted (low-frequency component of RR variability from 63.6Ϯ3.9 to 49.3Ϯ3 normalized units; PϽ0.001) by the stress management program, which also slightly lowered systolic arterial pressure. No changes were observed in the sham program group. This noninvasive study indicates that work stress is associated with unpleasant symptoms and with an altered autonomic profile and suggests that a stress management program could be implemented at the worksite, with possible preventive advantages for hypertension. (Hypertension. 2007;49:291-297.)
Job strain and cardiovascular risk factors: a cross sectional study of employed Danish men and women
British journal of industrial medicine, 1991
As part of the World Health Organisation initiated MONICA project, 2000 men and women aged 30, 40, 50, and 60 from the general population were invited to undergo a medical examination with special emphasis on cardiovascular disease. A total of 1504 (75%) participated, 1209 of whom were employed. The participants answered a questionnaire on working, social, and health conditions and underwent clinical examinations that included the measurement of blood pressure and serum cholesterol, triglyceride, high density lipoprotein, fibrinogen, and glycated haemoglobin (HbA1C) concentrations. Using the demand-control model for measuring job strain suggested by Karasek, the employed people were classified according to those who had suffered job strain and those who had not in two different ways. The subjective classification was based on the participants' statements regarding demand and control in their jobs whereas the objective classification was based on job title and mode of payment. Mo...