Schnall P L, Pieper C, Schwartz J E, Karasek R A, Schlussel Y, Devereux R B, Ganau A, Alderman M, Warren K, Pickering T G
Cardiovascular and Hypertension Center, New York Hospital-Cornell Medical College, New York 10021.
JAMA. 1990 Apr 11;263(14):1929-35.
To determine whether "job strain" (defined as high psychological demands and low decision latitude on the job) is associated with increased workplace diastolic blood pressure and the left ventricular mass index, we conducted a case-control study at seven urban work sites of 215 employed men aged 30 to 60 years without evidence of coronary heart disease. After comprehensive blood pressure screening of male employees (N = 2556) at the work site, 87 cases of hypertension and a random sample of 128 controls were studied. In a multiple logistic regression model, job strain was significantly related to hypertension, with an estimated odds ratio of 3.1, after adjusting for age, race, body-mass index, type A behavior, alcohol intake, smoking, work site, 24-hour urine sodium excretion, education, and physical demand level of the job. Controlling for the above variables in subjects aged 30 to 40 years with job strain, we found that the echocardiographically determined left ventricular mass index was, on average, 10.8 g/m2 greater than in subjects without job strain. We conclude that job strain may be a risk factor for both hypertension and structural changes of the heart in working men.
为了确定“工作压力”（定义为工作中高心理需求和低决策自由度）是否与工作场所舒张压升高及左心室质量指数增加相关，我们在七个城市工作场所对215名年龄在30至60岁且无冠心病证据的在职男性进行了一项病例对照研究。在对工作场所的男性员工（N = 2556）进行全面血压筛查后，对87例高血压病例和128名对照的随机样本进行了研究。在多元逻辑回归模型中，在调整了年龄、种族、体重指数、A型行为、酒精摄入量、吸烟情况、工作场所、24小时尿钠排泄量、教育程度和工作的体力需求水平后，工作压力与高血压显著相关，估计比值比为3.1。在30至40岁有工作压力的受试者中控制上述变量后，我们发现经超声心动图测定的左心室质量指数平均比无工作压力的受试者高10.8 g/m²。我们得出结论，工作压力可能是在职男性患高血压和心脏结构改变的一个危险因素。
