Staessen J A, Poulter N R, Fletcher A E, Markowe H L, Marmot M G, Shipley M J, Bulpitt C J
Department of Molecular and Cardiovascular Research, Katholieke Universiteit Leuven, Belgium.
J Cardiovasc Risk. 1994 Jun;1(1):45-51.
This study examined whether work-related aspects of stress, alone or in association with a high salt intake, are associated with a raised blood pressure.
A total of 384 male civil servants (35-51 years) collected a 24h urine sample and were interviewed using measures of work-related stress. Their blood pressure was taken at a civil-service medical clinic and was self-measured at home.
Systolic/diastolic pressure averaged ( +/- SD ) 135 +/- 19/84 +/- 14 mmHg at the clinic and 123 +/- 16/80 +/- 11 mmHG on self-measurements at home. The 24h urinary sodium excretion was 172 +/- 65 mmol. The overall stress score was categorized as low in 98 men, medium in 193 men and high in 93 men. Stress itself was not associated with an elevated pressure. However, in multivariate analyses with adjustments for age and body mass index, a stress-sodium interaction in the determination of the clinic systolic (P = 0.05) and diastolic (P = 0.08) pressure became apparent. At a sodium excretion of 100 mmol/24h (10th percentile), increasing stress from low to high was associated with a fall in pressure, averaging 4.5 mmHg for systolic pressure and 1.4 mmHg for diastolic pressure. By contrast, at 250 mmol/24h (90th percentile) the same stress increase was associated with a rise in pressure of 6.3 mmHg systolic and 5.9 mmHg diastolic.
The present study suggests that sodium intake and work-related stress may interact to determine blood pressure. This interaction is probably dynamic in nature, so that the contribution of each factor to blood pressure can only be determined if both are measured.
本研究旨在探讨与工作相关的压力因素，单独或与高盐摄入共同作用时，是否与血压升高有关。
共有384名年龄在35至51岁之间的男性公务员收集了24小时尿液样本，并接受了与工作相关压力的测量访谈。他们的血压在公务员医疗诊所测量，并在家中自行测量。
在诊所测量时，收缩压/舒张压平均为（±标准差）135±19/84±14 mmHg，在家中自行测量时为123±16/80±11 mmHg。24小时尿钠排泄量为172±65 mmol。总体压力得分在98名男性中为低，193名男性中为中，93名男性中为高。压力本身与血压升高无关。然而，在对年龄和体重指数进行调整的多变量分析中，压力-钠相互作用在诊所收缩压（P = 0.05）和舒张压（P = 0.08）的测定中变得明显。在钠排泄量为100 mmol/24小时（第10百分位数）时，压力从低到高增加与血压下降有关，收缩压平均下降4.5 mmHg，舒张压平均下降1.4 mmHg。相比之下，在250 mmol/24小时（第90百分位数）时，相同的压力增加与收缩压升高6.3 mmHg和舒张压升高5.9 mmHg有关。
本研究表明，钠摄入量和与工作相关的压力可能相互作用以决定血压。这种相互作用可能本质上是动态的，因此只有在同时测量这两个因素时，才能确定每个因素对血压的贡献。
