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On biochemical and physiological indicators of stress relevant to cardiovascular illness
... It may be defined as a combination of high demands and low decision latitude at work (27,28). Job strain can also activate the sympathetic and endocrine systems and induce elevated blood pressure and immune system changes (29)(30)(31)(32). Furthermore, it seems to increase sleep disturbance and reduce regenerative protective mechanisms (31,33). ...
... Job strain can also activate the sympathetic and endocrine systems and induce elevated blood pressure and immune system changes (29)(30)(31)(32). Furthermore, it seems to increase sleep disturbance and reduce regenerative protective mechanisms (31,33). Epidemiological studies have shown contradicting results, however, a recent review indicates an increased risk of cardiovascular disease associated with job strain (34). ...
Objectives:
The aim of this study was to assess the joint effect of job strain and both road-traffic and occupational noise on myocardial infarction (MI).
Method:
We conducted a population based case-control study on first time MI in Stockholm County during 1992-1994. Participants answered a questionnaire and underwent a physical examination. Residential road-traffic noise exposure was based on residential history combined with information on traffic intensity and distance to nearby roads. Occupational noise exposure was assessed by occupational history combined with a job-exposure matrix derived from measurements. Job strain was based on questions regarding psychological demands and decision latitude. A total of 3050 study participants (1252 cases and 1798 controls) were included in the study.
Results:
An increased risk of MI was indicated among participants exposed to road-traffic noise [odds ratio (OR) 1.23, 95% confidence interval (95% CI) 1.01-1.51], occupational noise (OR 1.17, 95% CI 0.98-1.41) and job strain (OR 1.39, 95% CI 1.17-1.65). Participants exposed to one, two, or three of these factors showed an increased risk (OR 1.16, 95% CI 0.97-1.40, OR 1.57, 95% CI 1.24-1.98, and OR 2.27, 95% CI 1.41-3.64, respectively). Exposure to two or three of these factors occurred among about 20% of the controls.
Conclusion:
Our results indicate that exposure to a combination of noise exposure and job strain increases the risk of MI substantially. Such exposures affect a considerable part of the population, which has relevance for prioritization of preventative measures.
... About 90% of the cortisol that is released into the blood steam is bound to the protein globulin, only 10% is free and active. Long-term stress may contribute to a dysfunction of the HPA-axis that may result in persistently increased levels of cortisol [13] and may eventually lead to metabolic changes and cardiovascular disease [14][15][16][17][18][19][20]. ...
In a population study, an attempt was made to answer the question whether people living in a street with much traffic (noise) run an increased risk of contracting cardiovascular diseases.The necessary cardiovascular data were provided by the Consultation Bureau Project Heart Diseases in a small town in The Netherlands. The study was restricted to housewives aged 40–49 years. Of 2,000 housewives 86% participated: 1342 living in quiet streets (Ldndn>62.5 dB(A)). For both groups, we studied the occurrence of consultation with a cardiologist, hypertension, angina pectoris, ischaemia on E.C.G., and heart shape pathology on X-ray photographs.No differences were found between the two groups of housewives. These results are discussed in the light of the question whether traffic noise can be a risk factor to cardiovascular disease. It is pointed out that the absolute exposure to traffic noise and the difference in exposure may have been too small to demonstrate an effect.
... Si se tiene en cuenta lo expuesto anteriormente, el estrés se reconoce como un factor muy importante a estudiar dentro del campo de las cardiopatías. Se ha evidenciado la asociación entre el estrés y los factores de riesgo, que son intermediarios en los marcadores fisiopatológicos en el proceso de las enfermedades coronarias (Pollard, 1997;Theorell, 1998;Kloner, 2004). El estrés está asociado con el desarrollo de arteriosclerosis coronaria, incremento de la masa del ventrículo izquierdo y calcificaciones coronarias. ...
Coronary artery disease is one of the most common diseases worldwide and constitutes a significant public health problem with high mortality rates. Studies of risk factors for coronary disease have begun to emphasize the importance of psychosocial factors such as stress, anger/hostility, anxiety, depression, and lack of social support. This review article will define and describe each factor and its relationship with the development and progression of coronary disease. La cardiopatía isquémica es una de las enfermedades más frecuentes a nivel mundial y constituye un importante problema de salud pública debido a sus altas tasas de mortalidad. Dentro de los factores de riesgo para el desarrollo y la progresión de las cardiopatías isquémicas, las investigaciones han comenzado a reconocer la importancia de los factores psicosociales, tales como el estrés, el complejo ira/hostilidad, la ansiedad, la depresión y el bajo apoyo social. Esta revisión teórica busca dar cuenta de las evidencias que apoyan estos factores como elementos importantes de estudio en el desarrollo, curso y desenlace de la cardiopatía isquémica.
To assess the effect on the fibrinogen concentration of sleep disturbance and mental stress, taking into account the effect of 21 other variables related to the risk of cardiovascular disease.
A cross-sectional study on men threatened by redundancy, and controls.
A health screening programme in Malmö, Sweden.
Four hundred and eighty five workers in a shipbuilding yard, scheduled for closure, and 190 age-matched men. The subjects were randomly selected from a larger group of shipyard workers and controls invited to a health screening programme. Mean age was 51.6 years (range 38-62 years).
Plasma fibrinogen concentration, serum cortisol concentration, body composition, blood pressure, heart rate, blood lipids, platelet number and size, white blood cell count, haemoglobin concentration, vital capacity, liver enzymes, blood glucose concentration fasting and after an oral glucose tolerance test. Questionnaire designed to evaluate muscle tension, sleep disturbance, anxiety, depression, job stress, alcohol and smoking habits and perceived health.
In stepwise regression analysis fibrinogen concentration was found to be correlated to white blood cell count, muscle tension, heart rate, body mass index, age and serum cholesterol concentration in non-smokers, which together explained 14.9% of the variation in fibrinogen concentration. In smokers, platelet count, heart rate, serum triglyceride concentration, age and fasting glucose explained 22.5% of the variation in fibrinogen concentration. The fibrinogen concentration was inversely correlated to the psychological variables, but unrelated to the serum cortisol concentration or to factors connected with the job situation, and it was decreased in moderate alcohol consumers.
Our interpretation of the findings is that an increase in the plasma fibrinogen concentration reflects the presence of a low-grade inflammatory process, and poor physical fitness.
As part of an assessment of stress during the training of guide dogs for the blind, blood pressures have been monitored in their main breeds. For this article a population of 227 Labradors, between 9 and 24 months of age, had indirect arterial blood pressures measured and means taken of five readings. They were ranked according to their pressures. Prior to the measurements, their character was independently assessed as "stress-prone" or "non-stress-prone" by their highly experienced and trained handlers. The pressure data distribution of stress-prone animals in the ranking was analysed; they were significantly more likely to be found at the high end of the blood pressure range for that population.
Research suggests that acute and chronic stress are risk factors for the development and progression of coronary artery disease. Much of this work is multidisciplinary, using unfamiliar concepts deriving from disciplines other than cardiology and medicine. This article addresses and clarifies, for the cardiologist, some of the key concepts and issues in this area and provides an overview of evidence linking acute and chronic stress to cardiac pathology. Areas addressed include definitions and measurement of mental stress, methodological issues in stress research, and distinctions between stress and variables such as personality, emotion, and depression. Mental stress is a multifactorial process involving the environment, individual experiences and coping, and a set of neuroendocrine, autonomic, cardiovascular, and other systemic physiologic responses. There are difficulties identifying a single consensus physiologic stress measure because of individual differences in perceptions and physiologic response patterns. Nonetheless, important associations exist between mental stress and clinically relevant cardiovascular end points. As multidisciplinary research in this area continues, one major goal is the better integration of psychosocial knowledge and measures with cardiology research and practice.
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