Lindquist T L, Beilin L J, Knuiman M W
Department of Medicine, University of Western Australia, Perth, Australia.
Hypertension. 1997 Jan;29(1 Pt 1):1-7. doi: 10.1161/01.hyp.29.1.1.
We designed this study to clarify the role of work stress on long-term blood pressure control and in particular to investigate whether perceived work stress directly affected resting blood pressure levels or whether there were indirect effects mediated by coping mechanisms and lifestyle. Men (n = 337) and women (n = 317) working in a government tax office completed questionnaires for assessment of work-related stress, coping strategies, and lifestyle. Seven resting blood pressure measurements were recorded serially on each of two occasions a week apart. Men had higher blood pressures (119.6/68.6 versus 110.9/65.6 mm Hg) than women; they used more "maladaptive" coping strategies, drank more alcohol, and ate less healthily but exercised more than women. There were no direct associations between measures of work stress and blood pressure. In univariate and regression analyses, both body mass index and lifestyle factors in the form of alcohol consumption, exercise, and diet were related to blood pressure in men and women. Various "adaptive" or "maladaptive" coping mechanisms were identified and independently related to both job stress and blood pressure levels. Women were more likely to use "healthier" or adaptive coping mechanisms than men. Thus, work stress per se had no direct effect on blood pressure, but the ways that individuals reported coping with stress were significantly related to blood pressure, with blood pressure elevation effects appearing to be mediated largely by dietary and drinking habits and physical inactivity. The results point to the need to target individual coping strategies and lifestyle as much as the working environment in workplace cardiovascular health promotion programs.
我们开展这项研究是为了阐明工作压力在长期血压控制中的作用，特别是调查感知到的工作压力是否直接影响静息血压水平，或者是否存在由应对机制和生活方式介导的间接影响。在政府税务办公室工作的男性（n = 337）和女性（n = 317）完成了有关工作相关压力、应对策略和生活方式的问卷调查。在相隔一周的两个时间段内，每周对每位参与者连续记录7次静息血压测量值。男性的血压（119.6/68.6 vs 110.9/65.6 mmHg）高于女性；他们使用更多“适应不良”的应对策略，饮酒更多，饮食更不健康，但比女性锻炼更多。工作压力测量值与血压之间没有直接关联。在单变量和回归分析中，体重指数以及饮酒、锻炼和饮食等生活方式因素均与男性和女性的血压有关。识别出了各种“适应性”或“适应不良”的应对机制，且它们与工作压力和血压水平均独立相关。女性比男性更有可能使用“更健康”或适应性的应对机制。因此，工作压力本身对血压没有直接影响，但个体应对压力的方式与血压显著相关，血压升高效应似乎主要由饮食习惯、饮酒习惯和缺乏身体活动介导。研究结果表明，在工作场所心血管健康促进项目中，除了关注工作环境外，还需要针对个体的应对策略和生活方式。
