Environmental Stress Linked to Chronic Hypertension : Health: Cornell report goes beyond previous studies. It found the most problematic jobs had both high pressure and little control over decisions.
WASHINGTON — Men--and presumably women--in demanding jobs with little freedom to make decisions have triple the risk of developing high blood pressure than is faced by others who have either a less-demanding job or more decision-making latitude, according to a new study by a group of Cornell Medical School researchers.
Previously, scientists had known with certainty only that stressful episodes--making a deadline, for example, or getting fired--could raise blood pressure temporarily.
But the article, published in today’s Journal of the American Medical Assn., suggests that difficult work environments can have a sustained, round-the-clock effect on hypertension. The study strengthens the widely held but unproven hypothesis that environmental stress increases the risk of heart disease.
The researchers cautioned that their results needed further validation, but the study raises the possibility that redesigning some high-strain jobs could make inroads against heart disease--the nation’s leading cause of death.
According to the study, the most problematic jobs were not those with a great deal of pressure to work hard and fast and where stress is unavoidable--like high-powered executive jobs commonly associated with heart attacks. Rather, environments found to increase blood pressure tended to be relatively low-level jobs where high psychological demands were combined with little control over the work process and little use of skills.
Most similar studies have focused on stress alone. This study also examined a person’s control over the situation. Lack of control, the researchers said, turns stress into strain. It found that if a high-stress job included latitude to control the situation, there was no increase in blood pressure.
“What appears to matter is coming to a job every day where the demands are high and the control is down and having to biologically turn on to manage these stresses and deal with these threats,” said Peter Schnall, a researcher at Cornell Medical School in New York. “The implication of our work is that (in order to increase the health of workers) we should start thinking about job design, about moving toward enhancement of skills, about better job training and increasing worker participation in decision-making.”
The study involved screening 2,556 men between the ages of 30 and 60, drawn from a newspaper typography department, a federal health agency, a stock brokerage firm, a liquor store, a private hospital, a sanitation collection and repair facility, and a department store warehouse. After giving comprehensive blood-pressure tests, the researchers selected 215 subjects: 87 suffered from hypertension and 128 acted as a control group.
After adjusting for all other factors that might have contributed to high blood pressure--including age, race, body mass, behavior, alcohol intake, smoking and physical demands of the job--the researchers found that workers whose jobs were “high strain” were 3.09 times as likely to have chronic high blood pressure as the control group.
