May 19 2004
Job strain and marital stress factors are a deadly blood pressure increasing duo, according to results of the Double Exposure study presented at the American Society of Hypertension’s Nineteenth Annual Scientific Meeting.
“The Double Exposure study was designed to determine if people under stress go on to develop higher levels of ambulatory blood pressure, possibly moving them along the pathway to hypertension,” said Sheldon Tobe, MD, lead investigator from Sunnybrook and Women’s Health Science Centre, Toronto. “Double Exposure refers to the possible interaction between job and marital factors on new and existing hypertension.
“Most job strain studies have been in men,” he explained. “Double Exposure looks at both men and women and psychosocial factors on sustained blood pressure. We wanted to see whether and how job strain and marital cohesion are related to ambulatory blood pressure over a 24 hour span, during work hours and in face-to-face contact with a spouse”
The investigators recruited 248 subjects (135 women and 113 men) from Sunnybrook and Women’s Health Science Centre, a large teaching hospital. Eligible subjects were working fulltime, in cohabiting relationships and untreated for hypertension. Their mean age was 50.8; 225 (91%) had some form of post-secondary education; 28 (11.6%) consumed more than 10 alcoholic drinks per week; 20 (8.1%) were smokers and 84 (34%) had high blood pressure.
Job strain was derived from the Job Content Questionnaire and marital cohesion from the Dyadic Adjustment Scale, two widely used and validated measurements. The investigators found 52 (21.3%) of the study participants had job strain, and 179 (72.2%) were in a satisfactory and cohesive relationship.
Ambulatory blood pressure monitors were used to record blood pressure. The monitor, a small non-invasive device, automatically measures blood pressure while the subjects are awake and while they are sleeping.
“Job strain was significantly associated with higher 24 hour systolic blood pressure compared to those without job strain, resulting in an average 5 mm Hg elevation in blood pressure,” Dr. Tobe said. “This effect to raise blood pressure was seen during work hours but was not as prominent when in the company of the spouse or during sleep.”
Systolic blood pressure, the first of the two blood pressure readings, is the measurement of pressure in blood vessels when the heart is pumping. Systolic blood pressure increases as people age and becomes a major risk factor for heart attacks and strokes. Diastolic pressure, the second reading, is the measurement
of pressure in blood vessels when the heart is at rest.
Dr. Tobe noted that other factors also linked to higher systolic blood pressure included older age, a higher body mass index and not exercising regularly.
“When in the company of the spouse, consuming more than 10 drinks of alcohol a week was a prominent factor in raising blood pressure,” he said. “This was associated with a 3.68 mm Hg elevation of systolic blood pressure during spousal contact.
“Excessive alcohol consumption was related to higher blood pressure during spousal contact, Dr. Tobe concluded. “The impact of marital factors as well as job strain on blood pressure will be further examined in the one year follow-up of the Double Exposure study, which concludes in June 2004.”
The American Society of Hypertension (ASH) is the largest US organization devoted exclusively to hypertension and related cardiovascular diseases. ASH is committed to alerting physicians, allied health professionals and the public about new medical options, facts, research findings and treatment choices designed to reduce the risk of cardiovascular disease. http://www.ash-us.org/