Job stress and the occupational gradient in coronary heart disease risk in women. The Stockholm Female Coronary Risk Study.
Job stress and the occupational gradient in coronary heart disease risk in women. The Stockholm Female Coronary Risk Study.
复制标题
女性冠心病风险的工作压力和职业梯度。
DOI：
10.1016/s0277-9536(00)00006-x
复制
发表时间：
2000
期刊：
影响因子：
--
通讯作者：
Orth-Gomér,K
中科院分区：
文献类型：
--
作者：
Wamala,SP;Mittleman,MA;Horsten,M;Schenck-Gustafsson,K;Orth-Gomér,K
最近对男性的研究表明，工作压力对于理解冠心病 (CHD) 的职业梯度很重要，但这些关系很少在女性中进行研究。随着劳动力中女性人数的增加，更全面地了解工作压力以及其他生物和行为风险因素如何介导冠心病风险非常重要。本研究的目的是检查当前就业女性中与工作压力和其他传统风险因素相关的冠心病风险的职业梯度。我们使用了斯德哥尔摩女性冠状动脉风险研究的数据，这是一项基于人群的病例对照研究，包括 292 名 65 岁或以下患有先心病的女性和 292 名年龄匹配的健康女性（对照）。职业类别与冠心病风险之间存在负相关关系。与最高职业（高管/专业）相比，最低职业级别（半熟练/非熟练）的女性患冠心病（CHD）的年龄调整风险增加了四倍（95% CI 1.75-8.83）。同时调整传统风险因素和工作压力，将这一风险降低至 2.45 (95% CI 1.01–6.14)。工作控制和卡拉塞克工作压力需求控制模型都不能从根本上解释最低职业阶层女性冠心病风险增加的原因。较低职业阶层的职业女性很可能面临多种且有时相互作用的工作和非工作压力来源，这些压力是由行为和生物因素介导的，会增加她们的冠心病风险。
Recent studies of men have shown that job stress is important in understanding the occupational gradient in coronary heart disease (CHD), but these relationships have rarely been studied in women. With increasing numbers of women in the workforce it is important to have a more complete understanding of how CHD risk may be mediated by job stress as well as other biological and behavioural risk factors. The objective of this study was to examine the occupational gradient in CHD risk in relation to job stress and other traditional risk factors in currently employed women. We used data from the Stockholm Female Coronary Risk Study, a population based case-control study, comprising 292 women with CHD aged 65 years or younger and 292 age-matched healthy women (controls). An inversely graded association was observed between occupational class and CHD risk. Compared with the highest (executive/professional), women in the lowest occupational class (semi/unskilled) had a four-fold (95% CI 1.75–8.83) increased age-adjusted risk for CHD. Simultaneous adjustment for traditional risk factors and job stress attenuated this risk to 2.45 (95% CI 1.01–6.14). Neither job control nor the Karasek demand-control model of job stress substantially explained the increased CHD risk of women in the lowest occupational classes. It is likely that lower occupational class working women face multiple and sometimes interacting sources of work and non-work stress that are mediated by behavioural and biological factors that increase their CHD risk.