Ohlin Bertil, Berglund Göran, Nilsson Peter M, Melander Olle
Department of Clinical Sciences/Medicine, Lund University, Malmö University Hospital, Sweden.
J Hypertens. 2008 Aug;26(8):1583-9. doi: 10.1097/HJH.0b013e328303df5f.
Job strain and the Arg389Gly polymorphism in the adrenergic beta1-receptor gene have been linked to hypertension. We aimed to study whether there is an interaction between the Arg389Gly polymorphism and job strain and its components (job demand and decision latitude) in relation to blood pressure.
From the Malmö Diet and Cancer population cohort, 6095 individuals were randomly selected to be followed regarding cardiovascular risk factors. From this group, employed individuals with baseline data regarding work characteristics were included (1338 men and 1707 women). Determination of adrenergic beta1-receptor Arg389Gly polymorphism was possible in 1271 men and 1601 women, and these individuals formed the study group.
Men with the combination of Arg389Arg and job strain were more often on antihypertensive medication (P = 0.04), whereas blood pressure was not significantly higher, in comparison with those without both of these two factors. The interaction term genotype x job strain was borderline significant for systolic blood pressure (P = 0.07) after adjustments for age, country of birth, and job status. The demand score showed significant interaction in men with genotype (P = 0.01 for systolic blood pressure and P = 0.009 for diastolic blood pressure) after adjustments for age, country of birth, job status, antihypertensive treatment, and BMI. Men with the Gly389 allele had lower blood pressure with increasing demand score (P = 0.001), whereas men homozygous for the Arg389 allele had lower blood pressure with increasing latitude score (P = 0.03). In women, those with job strain tended to have higher blood pressure than those without job strain, among carriers of Arg389Arg and Arg389Gly genotype.
Men with job strain and the Arg389Arg polymorphism were more often on antihypertensive treatment than other men. Significant interactions between the Arg389Gly polymorphism and aspects of job stress are described, but the absolute blood pressure differences are small. Considering the commonness of the polymorphism, stress, and hypertension further studies are indicated.
工作压力以及肾上腺素能β1受体基因中的Arg389Gly多态性与高血压有关。我们旨在研究Arg389Gly多态性与工作压力及其组成部分（工作要求和决策自由度）之间是否存在与血压相关的相互作用。
从马尔默饮食与癌症人群队列中随机选取6095人，对其心血管危险因素进行随访。从该组中纳入有工作特征基线数据的在职人员（1338名男性和1707名女性）。1271名男性和1601名女性能够进行肾上腺素能β1受体Arg389Gly多态性的测定，这些个体构成了研究组。
与没有这两个因素的男性相比，同时具有Arg389Arg和工作压力的男性更常使用抗高血压药物（P = 0.04），而血压并未显著升高。在对年龄、出生国家和工作状态进行调整后，基因型×工作压力的交互项对收缩压具有临界显著性（P = 0.07）。在对年龄、出生国家、工作状态、抗高血压治疗和体重指数进行调整后，需求评分在不同基因型的男性中显示出显著的交互作用（收缩压P = 0.01，舒张压P = 0.009）。携带Gly389等位基因的男性随着需求评分增加血压降低（P = 0.001），而纯合Arg389等位基因的男性随着自由度评分增加血压降低（P = 0.03）。在女性中，在Arg389Arg和Arg389Gly基因型携带者中，有工作压力的女性往往比没有工作压力的女性血压更高。
有工作压力且具有Arg389Arg多态性的男性比其他男性更常接受抗高血压治疗。描述了Arg389Gly多态性与工作压力各方面之间存在显著相互作用，但绝对血压差异较小。鉴于该多态性、压力和高血压的普遍性，需要进一步研究。
