Perceived Job Stress but not Individual Cardiovascular Reactivity to Stress Is Related to Higher Blood Pressure at Work

Abstract

Abstract-Psychological stress has been reported to be related to higher blood pressure (BP) and unfavorable cardiovascular profile. However, because of the complexity of personal stress management, a multilevel stress measurement strategy is needed. The aim of this cross-sectional study was to analyze the respective influences of the subjective perception of professional strain (high demand and low latitude) and cardiovascular reactivity to a stress test (Stroop stress test) on BP. Worksite BP was measured in 303 healthy normotensive subjects, 18 to 55 years of age, who worked in the same chemical company. In a subset of 70 randomly selected subjects, 24-hour ambulatory BP was performed to assess BP during working hours. The 20% of subjects who reported the highest job strain (high-strain group) or the highest BP stress reactivity (high-responder group) were compared with the remaining subjects (80%) (non-high-strain or low-responder groups). Subjects who submitted to the highest job strain had significantly higher ambulatory diastolic BP (4.5 mm Hg, Pϭ0.015) during only working hours, whereas BP was similar during the remaining hours. Worksite BP and stress cardiovascular reactivity were similar between job strain groups. BP stress reactivity did not influence worksite and ambulatory BP. Spontaneous BP variability assessed by standard deviation and spectral analysis was equivalent between complementary groups. Prevalence of microalbuminuria was significantly higher in the high-responder group (8.2% versus 2.5% in low responders) and only slightly higher in the high-strain group (6.2% versus 3.2% in non-high strain). Potential confounding factors, such as age, gender, alcohol consumption, salt intake, body mass index, and occupation, which were equivalent between groups, did not interfere with our results. Our study quantifies high-professional strain effects on BP levels that appear to be higher only during the working period and to be independent from spontaneous BP variability and stress BP reactivity. Key Words: stress Ⅲ blood pressure, ambulatory Ⅲ job strain Ⅲ microalbuminuria T he term "stress" is widely used by behavioral and biomedical scientists, but there is no consensus as to the scientifically precise definition of the concept. Selye's 1 basic concept of an organism's response to stress, the "general adaptation syndrome," infers that any kind of environmental strain results in a common defensive reaction that is the result of sympathetic activation leading to catecholamine release. However, physiological studies proved that the hormone response (epinephrine, norepinephrine, and steroids) may vary among the nature of stimulus. More recently, the psychological perception of stress has been emphasized because stress perception may differ among individuals. Psychological stressors are filtered by cognitive appraisal mechanisms before causing a biological response; thus, for the same strain, individual effects may differ. Because a multilevel measurement strategy is needed to quantify stress, 2 in this s...

Diurnal blood pressure variation and related behavioral factors

“…25 It has been shown that job stress is related to higher BP at work in normotensive subjects. 5,27 Another study showed that the BP response to daily stress was enhanced in hypertensive subjects compared with normotensive subjects. 28 Ambulatory BP during work was 10% higher than home BP in hypertensives, but the difference was only 3% in normotensives in this study.…”

Prevalence of hypertension in a University Community in South West Nigeria

“…The basis for the observed increase in hypertension prevalence with increasing number of children is not well known, however, considering the socio-economic challenges facing families in Nigeria, there are indications that higher number of children will increase stress though the respondent monthly salary appear to increase with the number of children. Psychological stress has been related to higher blood pressure and unfavorable cardiovascular profile ( Fauvel et al, 2001), and there is moderate support for psychological factors as predictors of hypertension development, with the strongest support for anger, anxiety, and depression variables. Pooled effects for these factors are of sufficient magnitude to suggest potential clinical as well as statistical relevance (Rutledge and Hogan, 2002).…”

Job Strain, Ethnicity, and Sympathetic Nervous System Activity

“…These studies generally demonstrate that job strain is associated with increased BP throughout the day and night. [3][4][5][6][7][8][9][10][11] Further, there is a greater incidence of myocardial infarction in individuals who report high job strain. 12 Although, there is considerable evidence that job strain has adverse effects on BP, little work has been performed examining the physiological mechanisms underlying the relationship between job strain and BP.…”