Chronic Stress, Daily Psychosocial Strain, and CVD Risk

越来越多的证据支持慢性应激在心血管疾病发展中的重要性 疾病(CVD)。这篇文献中最一致的一组发现之一是关于职业的研究 压力。越来越多的文献与“工作压力”模型一致，表明长期暴露在高度紧张的环境中 苛刻和无法控制的工作环境也可能与临床心血管疾病的发展有关 作为亚临床动脉粥样硬化。然而，关于潜在的机制，仍有许多需要了解 职业压力和心血管疾病之间的联系，以及这种机制在多大程度上是工作场所特有的。 例如，工作压力模型的一个假设是时时刻刻的行为过程 职业压力对健康的影响。这一假设很难用标准的 方法论。我们最近开发了最先进的计算机辅助非卧床评估 使我们能够在整个过程中捕捉精神压力的心理和生物标志的程序 日常生活的一部分。使用这些程序将使我们能够比以前更精确地检查 可能的，解释职业紧张对健康影响的机制。530名健康员工 (30-55岁)将接受动态血压(ABP)和电子日记评估 三个工作日和一个非工作日(周末)。全球职业压力评估也将 与心血管疾病的危险因素和生物标记物一起使用，包括颈动脉的超声测量 动脉硬化。我们将研究“日常心理社会压力”的作用，正如在自然界中实时评估的那样 环境，解释职业压力和心血管疾病生物标志物之间的联系。两者都是生物学的 因素(血液动力学和神经内分泌因素)和健康危险行为将被视为潜在的 解释这些影响的机制，这些模型已经被假设但从未明确测试过。这个 工作场所以外的日常需求在职业压力影响中的作用将是 刻画了性别与日常生活模式的关系，说明了性别差异 还将检查职业压力和心血管疾病的生物标记物。 相关性：确定职业压力可能通过的行为和生物机制 对心血管疾病的贡献对于制定适当的治疗目标和 旨在减少其影响的干预方法。

Accumulating evidence supports the importance of chronic stress in the development of cardiovascular disease (CVD). One of the most consistent set of findings in this literature is the research on occupational stress. A growing literature is consistent with the "job strain" model, showing that chronic exposure to highly demanding and uncontrollable work environments may be linked with the development of clinical CVD as well as subclinical atherosclerosis. Much remains to be understood, however, about the potential mechanisms linking occupational stress and CVD, and the degree to which such mechanisms are specific to the workplace. For example, one assumption of the job strain model is that moment-to-moment behavioral processes account for the effects of occupational stress on health. This assumption is difficult to test using standard methodologies. We have recently developed state-of-the art computer-assisted ambulatory assessment procedures that allow us to capture the psychological and biological markers of mental stress over the course of daily life. Use of these procedures will allow us to examine, more precisely than has previously been possible, the mechanisms accounting for the health effects of occupational stress. 530 healthy employees (ages 30-55) will be administered ambulatory blood pressure (ABP) and electronic diary assessments over three working days and one nonworking (weekend) day. Global assessments of occupational stress will also be employed, along with risk factors and biomarkers for CVD, including ultrasound measures of carotid artery atherosclerosis. We will examine the role of "daily psychosocial strain," as assessed in real time in the natural environment, in explaining the association between occupational stress and CVD biomarkers. Both biological factors (hemodynamic and neuroendocrine factors) and health risk behaviors will be examined as potential mechanisms accounting for these effects, models that have been hypothesized but never explicitly tested. The role of daily demands outside of the workplace in contributing to the effects of occupational stress will be characterized, and the patterns of daily living accounting for sex differences in the relationship between occupational stress and biomarkers for CVD will also be examined. RELEVANCE: Identifying the behavioral and biological mechanisms by which occupational stress may contribute to cardiovascular disease is of critical importance for developing appropriate treatment targets and methods of intervention designed to reduce its effects.