Supportive spouse helps lower blood pressure

When job strain causes stress, a supportive spouse might help lower the negative impact on a person's blood pressure, according to a study presented at the 2005 American Heart Association's High Blood Pressure Research meeting.

In a presentation called "Double Exposure: The One-Year Impact of Job Strain and Marital Cohesion on Ambulatory Blood Pressure," researchers reported the results of a Canadian study conducted with 216 male and female volunteers over one year.

"The study found job strain had a significant impact, both clinically and statistically, on blood pressure," said lead author Sheldon Tobe, M.D., assistant professor of medicine at the University of Toronto, Ontario, Canada.

Job strain and low marital cohesion, or a lack of support from a spouse, was related to an increase of systolic 2.8 mmHg of blood pressure over one year. High marital cohesion in the presence of job strain was related to a decrease of 2.5 systolic blood mmHg over one year.

The study population was 77 percent Caucasian; ages ranged from 40 to 65 years.

Physicians, nurses, administrators, maintenance workers and others working at the University of Toronto Health Sciences Center represented about two-thirds of the study group. Visitors to the university accounted for the rest.

At baseline, the volunteers were employed and living with a significant other for the previous six months and were not receiving medication for high blood pressure.

Blood pressure was measured at baseline and at one year with an ambulatory blood pressure monitor over 24 hours of a usual workday. At baseline, 34 percent of the group had ambulatory blood pressure of 130/80 mmHg or higher.

Researchers administered the Job Content Questionnaire, a widely used and well-validated test for job strain. Those with job strain were in the lowest twentieth percentile of the key component of high job demands and low decision latitude. "The key components of job strain are high job demand and low decision latitude," Tobe said.

"An example might be an operating room nurse who has high job demand, meeting physical and mental demands and low latitude for making personal decisions while on the job such as going for a lunch break," he said.

Marital cohesion was evaluated by administering the Dyadic Adjustment Scale, a widely used and established test.

"The amount of support given at home in the relationship is a major definition of marital cohesion," Tobe said. "Did the partners talk about their daily activities? Did one partner pay attention and sympathize when the significant other had a stressful day? Did the partners spend time together?"

There's a practical use for the information coming from this study, Tobe said. He advised that people who have high job strain and/or low marital cohesion should see their family doctor for a blood pressure check. If a harmonious relationship has deteriorated, blood pressure needs to be checked.

"Health practitioners need to be aware that job strain does cause illness," Tobe said. "The medical model of healthcare does not include job strain, but stress at work and at home can modify the health of patients."