Hassoun Lina, Herrmann-Lingen Christoph, Hapke Ulfert, Neuhauser Hannelore, Scheidt-Nave Christa, Meyer Thomas
From the Department of Psychosomatic Medicine and Psychotherapy (Hassoun, Herrmann-Lingen, Meyer), University of Göttingen, Göttingen, Germany; Department of Epidemiology and Health Monitoring, Robert Koch Institute (Hapke, Neuhauser, Scheidt-Nave), Berlin, Germany; and German Center for Cardiovascular Research (Hassoun, Herrmann-Lingen, Meyer, Neuhauser, Scheidt-Nave), Göttingen, Germany.
Psychosom Med. 2015 Jun;77(5):575-82. doi: 10.1097/PSY.0000000000000183.
The magnitude of the contribution of psychosocial stressors to the development of hypertension remains controversial. Using data from the population-based, nationwide German Health Interview and Examination Survey for Adults, we investigated the relationship between objectively measured and subjectively perceived stressors and blood pressure (BP).
The study sample comprised 3352 participants not taking antihypertensive medication, for whom data on stress exposure and resting BP measurements were available. The Trier Inventory for the Assessment of Chronic Stress screening scale (TICS-SSCS) was used as a measurement of self-perceived chronic stress, and work-related stress was assessed using the recently developed occupational Overall Job Index.
On the basis of bivariate tests, TICS-SSCS was negatively associated with both systolic (β-coefficient [B] = -0.16, standard error = 0.03, p < .001) and diastolic BP (B = -0.10, standard error = 0.02, p < .001). After adjustment for age, sex, and body mass index, the TICS-SSCS but not the Overall Job Index was significantly related to systolic and diastolic BP. When alcohol consumption, smoking, physical activity, residential traffic intensity, caregiving, socioeconomic status, social support, and living without a partner were added to the model, the TICS-SSCS again remained independently associated with both BP measures (p ≤ .007).
In a large and representative German study, we found that less perceived stress is associated with higher BP levels, whereas the exposure to objective stressors was unrelated to BP. These findings suggest that stress perception and objective stressors influence BP regulation via different biobehavioral pathways.
心理社会压力源对高血压发展的贡献程度仍存在争议。利用基于人群的全国性德国成人健康访谈与检查调查的数据，我们研究了客观测量和主观感知的压力源与血压（BP）之间的关系。
研究样本包括3352名未服用抗高血压药物的参与者，他们有压力暴露和静息血压测量数据。使用特里尔慢性压力评估量表（TICS - SSCS）来测量自我感知的慢性压力，并使用最近开发的职业总体工作指数来评估工作相关压力。
基于双变量检验，TICS - SSCS与收缩压（β系数[B]= - 0.16，标准误 = 0.03，p <.001）和舒张压（B = - 0.10，标准误 = 0.02，p <.001）均呈负相关。在调整年龄、性别和体重指数后，TICS - SSCS而非总体工作指数与收缩压和舒张压显著相关。当将饮酒、吸烟、身体活动、居住交通强度、护理、社会经济地位、社会支持以及无伴侣生活等因素添加到模型中时，TICS - SSCS再次与两种血压测量值独立相关（p≤.007）。
在一项大型且具有代表性的德国研究中，我们发现感知到的压力较小与较高的血压水平相关，而客观压力源的暴露与血压无关。这些发现表明，压力感知和客观压力源通过不同的生物行为途径影响血压调节。
