Roohafza Hamidreza, Sattari Niloofar, Nouri Fatemeh, Talaei Mohammad, Masoumi Gholamreza, Sarrafzadegan Nizal, Sadeghi Masoumeh
Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Hypertens Res. 2022 Jun;45(6):1058-1066. doi: 10.1038/s41440-022-00895-3. Epub 2022 Apr 4.
Stress has been suggested as a contributing factor in the etiology and progression of hypertension in prior investigations. For a more comprehensive understanding of this concept, in this study, we aim to evaluate different domains of perceived stress and their possible contribution to the development of hypertension (HTN). This is a secondary analysis of the Isfahan Cohort Study (ICS). We used data from 2007 and 2013. The 12-item General Health Questionnaire (GHQ-12) and Stressful Life Events Questionnaire (SLEQ) were used to evaluate psychological distress and perceived stress in subjects, and a generalized linear mixed model (GLMM) was used to assess their association with HTN. Psychological distress had a significant positive relation with HTN that remained after full adjustment for other covariates. Individuals with high stress levels were 38% more likely to develop HTN (OR 1.38, 95% CI 1.18, 1.59). After full adjustment, total perceived stress was significantly associated with a 15% increase in HTN development (OR 1.15, 95% CI 1.01-1.29). Domains of perceived stress that were significantly associated with HTN independent of sociodemographic and lifestyle covariates were job conflict, job security, personal conflict, sexual life and daily life in both genders and financial problems in males (P < 0.01). The findings from this study underline the importance of identifying the effect of different sources of perceived stress to organize community-based strategies for the management of hypertension and help health professionals prioritize and efficiently allocate their resources for interventions.
在先前的研究中，压力已被认为是高血压病因及进展的一个促成因素。为了更全面地理解这一概念，在本研究中，我们旨在评估感知压力的不同领域及其对高血压（HTN）发展的可能影响。这是对伊斯法罕队列研究（ICS）的二次分析。我们使用了2007年和2013年的数据。采用12项一般健康问卷（GHQ - 12）和应激性生活事件问卷（SLEQ）来评估受试者的心理困扰和感知压力，并使用广义线性混合模型（GLMM）来评估它们与高血压的关联。心理困扰与高血压呈显著正相关，在对其他协变量进行完全调整后依然如此。高压力水平的个体患高血压的可能性高出38%（比值比1.38，95%置信区间1.18，1.59）。完全调整后，总感知压力与高血压发展增加15%显著相关（比值比1.15，95%置信区间1.01 - 1.29）。与高血压显著相关且独立于社会人口统计学和生活方式协变量的感知压力领域，在男女中均为工作冲突、工作保障、人际冲突、性生活和日常生活，在男性中还有财务问题（P < 0.01）。本研究结果强调了识别不同来源的感知压力影响的重要性，以便制定基于社区的高血压管理策略，并帮助卫生专业人员确定干预重点并有效分配资源。
