Coping with Unfair Treatment at Work – What Is the Relationship between Coping and Hypertension in Middle-Aged Men and Women?

Abstract

Background: An important hypothesis in psychosomatic medicine is that exposure to psychosocial factors that arouse anger may accelerate the onset of hypertension, particularly if the subject is not allowed to show anger or to deal constructively with the factor that evoked it. For working men and women, being treated in an unfair way at work may be crucial. The present study was designed to answer the question whether the pattern of coping – primarily directed towards the aggressor (open) or directed inwards or towards others (covert) – is associated with hypertension among working men and women. Study group: Five thousand seven hundred and twenty working men and women aged 15–64 participated in the study. The participation rate was 76%. Methods: The coping pattern was studied by means of a Swedish version of a self-administered questionnaire that was originally introduced by Harburg et al. Results: Significant results were confined to the age group 45–54. All analyses were adjusted for age and body mass index. Smoking habits and social class had no effect on the relationships. Low scores (lowest quartile) for open coping tended to be associated with an elevated prevalence ratio (PR) of hypertension both among men (PR 1.3, 95% confidence interval, CI, 0.9–1.7) and women (PR 1.4, 95% CI 1.0–2.0). High scores for covert coping (highest quartile) were associated with an elevated PR of hypertension among men (PR 1.6, 95% CI 1.2–2.2) but not in women. If the analysis was confined to cases without medication, the relationship between a high level of covert coping and high blood pressure was still significant for men. For women, however, no significant findings were made after this operation. Accordingly, the relationship between a low level of open coping and hypertension in women was confined to women with medication. Coping patterns were correlated with psychosocial work environment factors, in particular decision latitude. Conclusion: In men, covert coping was associated with prevalence of hypertension. In women, there tended to be a relationship between low scores for open coping and hypertension.

Unfair treatment and self-regulatory focus

“…Ayduk, May, Downey, and Higgins (2003) showed that prevention-focused and rejection sensitive individuals were prone to use covert strategies to cope with rejection. Covert coping is associated with high blood pressure (Theorell, Alfredsson, Westerholm, & Falck, 2000) and signs of coronary heart disease (Harenstam, Theorell, & Kaijser, 2000). However, it is also possible that prevention focus can have positive consequences of appropriately alerting individuals to the potential for danger and appropriately turning on "take care" responses.…”

The Association of the Reporting of Somatic Symptoms with Job Stress and Active Coping among Japanese White‐collar Workers

“…This refers to the extent to which employees are treated justly in their workplace and consists of two components: justice concerning decision-making procedures and interpersonal treatment 25) . Previous studies have shown that lower levels of justice are associated with lower well-being, higher self-reported morbidity, higher medically certified absences, increased mental health problems, and a greater likelihood of maladaptive coping [25][26][27][28] . Hence, the introduction of a health program that improves active coping may be useful for improving the levels of perceived justice.…”

Occupational stress and cardiovascular disease

“…However, beyond the strict confi nes of theoretical models of OS, the prevalence of hyperten-sion have also been associated with organizational job constraints (Radi, et al, 2005), excessive work hours (Yang, Schnall, Jauregui, Su, & Baker, 2006), job insecurity and low occupational prestige, but only in men (Levenstein, Smith, & Kaplan, 2001), covert coping with unfair treatment at work, but only in men (Theorell, Alfredsson, Westerholm, & Falck, 2000), perceived job barriers and job intensity (Greiner, Krause, Ragland, & Fisher, 2004), and race-related workplace stress (Din-Dzietham, Nembhard, Collins, & Davis, 2004). The evidence implicating OS in the genesis of hypertension is therefore persuasive though much of it goes beyond the framework of established theoretical models.…”