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Cited by 232Cardiovascular Health and Disease PreventionWorkplace Health and Well-beingBlood Pressure and Hypertension Studies

The DOI matches its Crossref record; 103 of the 103 references it cites were found in a registry or an index.

Interaction of workplace demands and cardiovascular reactivity in progression of carotid atherosclerosis: population based study

Open access
Everson, Susan A, Lynch, John W, Chesney, Margaret A, Kaplan, George A, Goldberg, Debbie E, Shade, Starley B, Cohen, Richard D, Salonen, Riitta, Salonen, Jukka T·1997·BMJ
DOI 10.1136/bmj.314.7080.553PMC PMC2126071
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Abstract

Objective: To examine the combined influence of workplace demands and changes in blood pressure induced by stress on the progression of carotid atherosclerosis. Design: Population based follow up study of unestablished as well as traditional risk factors for carotid atherosclerosis, ischaemic heart disease, and other outcomes. Setting: Eastern Finland. Subjects: 591 men aged 42-60 who were fully employed at baseline and had complete data on the measures of carotid atherosclerosis, job demands, blood pressure reactivity, and covariates. Main outcome measures: Change in ultrasonographically assessed intima-media thickness of the right and left common carotid arteries from baseline to 4 year follow up. Results: Significant interactions between workplace demands and stress induced reactivity were observed for all measures of progression (P<0.04). Men with large changes in systolic blood pressure (20 mm Hg or greater) in anticipation of a maximal exercise test and with high job demands had 10-40% greater progression of mean (0.138 v 0.123 mm) and maximum (0.320 v 0.261 mm) intima-media thickness and plaque height (0.347 v 0.264) than men who were less reactive and had fewer job demands. Similar results were obtained after excluding men with prevalent ischaemic heart disease at baseline. Findings were strongest among men with at least 20% stenosis or non-stenotic plaque at baseline. In this subgroup reactive men with high job demands had more than 46% greater atherosclerotic progression than the others. Adjustment for atherosclerotic risk factors did not alter the results. Conclusions: Men who showed stress induced blood pressure reactivity and who reported high job demands experienced the greatest atherosclerotic progression, showing the association between dispositional risk characteristics and contextual determinants of disease and suggesting that behaviourally evoked cardiovascular reactivity may have a role in atherogenesis. Key messages: Psychological stress plays an important part in the illness and premature death associated with cardiovascular disease, but individual susceptibility to disease varies according to biological predispositions, personality, behaviour, and environmental exposures This study found that a demanding work environment in combination with a predisposition to exaggerated blood pressure reactivity to stress was significantly related to progression of carotid atherosclerosis over four years among employed middle aged men and was independent of known atherosclerotic risk factors These findings support the role of stress induced reactivity in human atherogenesis Future research needs to confirm these findings in other populations and to examine the influence of other risk factors and environments on the progression of disease

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Crossref · 10.1136/bmj.314.7080.553

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Research works printed but not linked: 3

  1. Lynch JL Krause N Kaplan GA Tuomilehto J Salonen JT .Workplace demands and resources, economic reward and the risk of mortality and acute myocardial infarction. Prospective evidence from the Kuopio ischemic heart disease risk factor study. Am J Public Health (in press).
  2. Salonen R Salonen JT .Intima-media changes in a population study: KIHD. In: Boccalon H , ed. Vascular medicine. Amsterdam:Elsevier Science Publishers,1993:301–4.
  3. Evans, 1996, Risk factors for carotid atherosclerosis progression: The ARIC study., Circulation, 93, 629

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Metadata

Authors
Everson, S. A., Lynch, J. W., Chesney, M. A., Kaplan, G. A., Goldberg, D. E., Shade, S. B., Cohen, R. D., Salonen, R., & Salonen, J. T.
Affiliations
  • Human Population Laboratory (US)
  • University of California, San Francisco (US)
  • University of Eastern Finland (FI)
ORCID
Venue
BMJ
Publisher
BMJ
Published
1997-02-22
Volume
314
Issue
7080
Pages
553
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.314.7080.553
PMC
PMC2126071
OpenAlex
W2007497220
Cited by
232
References
100
Citations by year
2026: 5 · 2025: 3 · 2023: 4 · 2022: 4 · 2021: 3 · 2020: 6 · 2019: 1 · 2018: 6 · 2017: 10 · 2016: 5 · 2015: 6 · 2014: 7 · 2013: 10 · 2012: 10
FWCI
7.55
Type
journal article
Language
en
Open access
Licence
www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations
  • BMJ (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Deep Blue (University of Michigan) (submittedVersion)
Funders
  • John D. and Catherine T. MacArthur Foundation (HS06516)
  • University of Dundee
  • British Heart Foundation (HS06516)
  • Health and Safety Executive
  • Academy of Finland
  • Medical Research Council (HS06516)
  • National Heart, Lung, and Blood Institute (HL-44199, HS06516, HL36310, R01HL044199)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
carotid atherosclerosis, atherosclerosis progression, job demands, occupational stress, blood pressure reactivity, cardiovascular reactivity, intima-media thickness, carotid plaque, middle-aged men, ischemic heart disease, atherogenesis, psychological stress, risk factor interactions, blood pressure response to exercise, carotid artery stenosis, Eastern Finland
MeSH terms
Adult, Arteriosclerosis, Blood Pressure, Carotid Artery Diseases, Exercise Test, Finland, Follow-Up Studies, Humans, Life Style, Male, Middle Aged, Occupational Diseases, Stress, Psychological, Carotid Stenosis, Workplace, Myocardial Ischemia, Disease Progression

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