Panagiotakos D B, Chrysohoou Ch, Pitsavos Ch, Antoniou S, Vavouranakis E, Stravopodis P, Moraiti A D, Stefanadis Ch I, Toutouzas P K
Section of Preventive Cardiology, Department of Cardiology, School of Medicine, University of Athens Hellenic Heart Foundation, Athens, Greece.
Cent Eur J Public Health. 2003 Mar;11(1):25-30.
The aim of this study was to investigate the association between occupational stress and the risk of developing acute coronary syndromes, in a population-based sample of patients and controls.
During 2000-01, a case-control study was conducted (CARDIO2000). A random and stratified sample of 848 middle aged patients with a first of an acute coronary syndrome and 1078 cardiovascular disease free participants, matched with the patients by gender, age and region, was selected from all regions of Greece. In addition to the common cardiovascular risk factors, the effect of occupational stress on coronary risk was evaluated, after taking into account income, marital status, educational and occupational level of the participants. The levels of occupational stress were measured by administering to the individuals a self-reported questionnaire.
After controlling for age, gender and region, by design, and the presence of smoking, hypertension, hypercholesterolaemia, diabetes mellitus, physical activity status, educational and financial status and nutritional habits, multivariate analysis showed that the levels of occupational stress are positively associated with the risk of developing acute coronary syndromes in the investigated sample (Odds Ratio = 2.2, p < 0.01). Moreover, the presence of occupational stress seems to affect more significantly males than females, smokers than non-smokers, hypertensives than normotensives and high alcohol consumers compared to low alcohol consumers.
Although the design of the present study does not provide evidence of causality, a strong positive association between occupational stress and acute coronary syndromes seems to exist. Thus, public health policies should take into account lifestyle conditions related to work in the design of preventive strategies at the primary level.
本研究旨在调查在以人群为基础的患者和对照样本中，职业压力与急性冠状动脉综合征发病风险之间的关联。
在2000 - 2001年期间，开展了一项病例对照研究（CARDIO2000）。从希腊所有地区随机分层抽取了848例首次发生急性冠状动脉综合征的中年患者以及1078例无心血管疾病的参与者，后者按性别、年龄和地区与患者进行匹配。除了常见的心血管危险因素外，在考虑参与者的收入、婚姻状况、教育和职业水平后，评估职业压力对冠心病风险的影响。通过向个体发放一份自我报告问卷来测量职业压力水平。
按照设计，在控制了年龄、性别和地区以及吸烟、高血压、高胆固醇血症、糖尿病、身体活动状况、教育和财务状况及营养习惯的存在情况后，多变量分析显示，在所研究的样本中，职业压力水平与急性冠状动脉综合征的发病风险呈正相关（比值比 = 2.2，p < 0.01）。此外，职业压力的存在似乎对男性的影响比对女性更显著，对吸烟者比对非吸烟者更显著，对高血压患者比对血压正常者更显著，对高酒精摄入量者比对低酒精摄入量者更显著。
尽管本研究的设计未提供因果关系的证据，但职业压力与急性冠状动脉综合征之间似乎存在很强的正相关。因此，公共卫生政策在初级预防策略设计中应考虑与工作相关的生活方式条件。
