Siegrist J
Institute of Medical Sociology, Heinrich-Heine-University, Düsseldorf, Germany.
Patient Educ Couns. 1995 Jul;25(3):227-36. doi: 10.1016/0738-3991(95)00805-a.
A large number of patients suffer from cardiovascular (CV) risk and disease. While many of them have experienced chronic emotional distress at work or at home as a subjectively important risk factor, clinical medicine has so far often disregarded the role of emotional distress in the pathogenesis of CV disease. However, new findings show striking associations. This paper summarizes the evidence from 3 epidemiologic studies on work-related distress and CV risk in middle-aged male populations. The empirical work is based on a theoretical model termed effort-reward imbalance. Workers who exhibit high effort in combination with low reward, and especially with low job security or promotion prospects, suffer from a 3- to 4-fold increased risk of CV disease, and they exhibit higher blood pressure, blood lipids and fibrinogen. Implications of these findings for prevention and intervention are discussed.
大量患者存在心血管（CV）风险和疾病。虽然他们中的许多人在工作或家庭中经历过慢性情绪困扰，这是一个主观上重要的风险因素，但到目前为止，临床医学常常忽视情绪困扰在心血管疾病发病机制中的作用。然而，新的研究结果显示出显著的关联。本文总结了三项关于中年男性人群工作相关困扰与心血管风险的流行病学研究证据。实证研究基于一个名为努力-回报失衡的理论模型。表现出高努力但回报低，尤其是工作保障或晋升前景低的员工，患心血管疾病的风险增加3至4倍，并且他们的血压、血脂和纤维蛋白原水平更高。文中还讨论了这些研究结果对预防和干预的意义。
