Pilgrim J A, Stansfeld S, Marmot M
Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine.
BMJ. 1992 Jan 11;304(6819):75-8. doi: 10.1136/bmj.304.6819.75.
To determine whether a set of physical symptoms is associated with low blood pressure and to investigate the possible role of psychological factors in their occurrence.
Analysis of data collected by questionnaire and physical screening from the first phase of the Whitehall II study, a cohort study of an employed population.
23 civil service departments in London.
10,314 male and female London based civil servants aged between 35 and 55.
Symptoms of dizziness-giddiness and unexplained tiredness; psychological functioning as measured by the 30 item general health questionnaire in which the response "no more than usual" to an item about disease was scored as indicating chronic illness.
Dizziness-giddiness in men and unexplained tiredness in both men and women were significantly related to low systolic blood pressure. There was a highly significant inverse relation between general health questionnaire score and systolic blood pressure for both men and women, which persisted after controlling for potentially confounding variables, including age, body mass index, drug treatment, physical illness, and exercise. This association of low blood pressure with physical symptoms was no longer significant when general health questionnaire score was controlled for.
There seems a strong relation between low systolic blood pressure and minor psychological dysfunction. Associated physical symptoms seem to be secondary to the primary disturbance in mental state.
确定一组身体症状是否与低血压有关,并调查心理因素在这些症状发生过程中可能起到的作用。
对怀特霍尔二期研究第一阶段通过问卷调查和身体筛查收集的数据进行分析,该研究是一项针对在职人群的队列研究。
伦敦的23个公务员部门。
10314名年龄在35至55岁之间、工作地点在伦敦的男女公务员。
头晕目眩和无法解释的疲劳症状;通过30项一般健康问卷衡量心理功能,其中对一项关于疾病的问题回答“不超过平常”被视为表明患有慢性病。
男性的头晕目眩以及男性和女性无法解释的疲劳都与收缩压降低显著相关。男性和女性的一般健康问卷得分与收缩压之间存在高度显著的负相关,在控制了包括年龄、体重指数、药物治疗、身体疾病和运动等潜在混杂变量后这种相关性依然存在。当控制了一般健康问卷得分后,低血压与身体症状之间的这种关联不再显著。
收缩压降低与轻微心理功能障碍之间似乎存在密切关系。相关的身体症状似乎是精神状态原发性紊乱的继发表现。