Effects of work stress on ambulatory blood pressure, heart rate, and heart rate variability
Effects of work stress on ambulatory blood pressure, heart rate, and heart rate variability
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DOI：
10.1161/01.hyp.35.4.880
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发表时间：
2000-04-01
期刊：
影响因子：
8.3
通讯作者：
de Geus, EJC
中科院分区：
文献类型：
--
作者：
Vrijkotte, TGM;van Doornen, LJP;de Geus, EJC
工作压力一再被认为与心血管疾病的风险增加有关。这项研究测试了这种关系是否可以用工作时心血管反应过度或休闲时间恢复受损来解释。迷走神经张力被评估为这些工作压力效应的可能决定因素。参与者包括109名男性白领(年龄47.2+/-5.3)，他们在2个工作日和1个非工作日进行了动态血压、心率和心率变异性的监测。根据Siegrist的模型，慢性工作压力被定义为(1)高度不平衡，工作中高努力和低回报的组合，或(2)高度过度承诺，一种与工作相关的穷尽应对方式，表明无法放松。所有研究结果都针对工作压力组之间在姿势和体力活动方面可能存在的差异进行了调整。高不平衡与工作期间和工作后直接心率较高，工作和休闲时间较高的收缩压，以及在所有三个测量日的24小时迷走神经张力较低相关。过度承诺与不良的活动状态无关。Logistic回归分析显示心率[优势比1-SD增加1.95(95%CI，1.02至3.77)]和迷走神经张力[优势比I-SD下降2.67(95%CI，1.24至5.75)]与轻度高血压独立相关。令人惊讶的是，睡眠中的数值比工作中的数值更能预测轻度高血压。目前的研究结果表明，工作压力的有害影响部分是通过增加心率对紧张工作日的反应性、增加收缩压水平和降低迷走神经张力来实现的。
Work stress has repeatedly been associated with an increased risk for cardiovascular disease. This study tested whether this relationship could be explained by exaggerated cardiovascular reactivity to work or impaired recovery in leisure time. Vagal tone was assessed as a possible determinant of these work stress effects. Participants included 109 male white-collar workers (age, 47.2 +/- 5.3) who were monitored on 2 workdays and 1 nonworkday for ambulatory blood pressure, heart rate, and heart rate variability. Chronic work stress was defined according to Siegrist's model as (1) high imbalance, a combination of high effort and low reward at work, or (2) high overcommitment, an exhaustive work-related coping style indexing the inability to unwind. All findings were adjusted for possible differences in posture and physical activity between the work stress groups. High imbalance was associated with a higher heart rate during work and directly after work, a higher systolic blood pressure during work and leisure time, and a lower 24-hour vagal tone on all 3 measurement days. Overcommitment was not associated with an unfavorable ambulatory profile. Logistic regression analysis revealed that heart rate [odds ratio 1-SD increase 1.95 (95% Cl, 1.02 to 3.77)] and vagal tone [odds ratio I-SD decrease 2.67 (95% Cl, 1.24 to 5.75)] were independently associated with incident mild hypertension. Surprisingly, the values during sleep were more predictive for mild hypertension than the values during work. The results from the present study suggest that the detrimental effects of work stress are partly mediated by increased heart rate reactivity to a stressful workday, an increase in systolic blood pressure level, and lower vagal tone.