Psychosocial stress in relation to blood pressure and cardivascular disease - epidemiological and genetic aspects
(2007) In Lund University Faculty of Medicine Doctoral Dissertation Series- Abstract
- Psychosocial stress has been linked to both hypertension and cardiovascular disease
(CVD), and hypertension has been proposed to be one mediator of the increased CVD
risk in subjects reporting stress. Genetic susceptibility for blood pressure elevation in
relation to stress has been proposed, but so far there is little evidence. We aimed to
study the prospective CVD risk of chronic stress (Paper I), and the prospective effect on
blood pressure levels of work-related stress (Paper II). In Papers III-IV the aim was to
explore a hypothesised work stress?gene interaction in relation to blood pressure.
In Paper I,... (More) - Psychosocial stress has been linked to both hypertension and cardiovascular disease
(CVD), and hypertension has been proposed to be one mediator of the increased CVD
risk in subjects reporting stress. Genetic susceptibility for blood pressure elevation in
relation to stress has been proposed, but so far there is little evidence. We aimed to
study the prospective CVD risk of chronic stress (Paper I), and the prospective effect on
blood pressure levels of work-related stress (Paper II). In Papers III-IV the aim was to
explore a hypothesised work stress?gene interaction in relation to blood pressure.
In Paper I, 13,306 participants (2741 women) from the population-based screening and
intervention programme Malmö Preventive Project were followed for a median of 21
years. Men and women with self-reported chronic stress at baseline suffered an
increased risk of cardiovascular events compared to those without baseline stress (RR
1.27; 95%CI 1.15-1.27). The statistical significances were stronger in men than in
women.
In Papers II-IV different sub-cohorts from the population-based Malmö Diet and Cancer
Study (MDCS) were included. Work stress was assessed according to the Karasek
demand-control model. In Paper II, men with baseline job strain (?stress?) had a
significantly greater systolic blood pressure (SBP) and diastolic blood pressure (DBP)
elevation at follow-up compared to men with relaxed working conditions (significance for
difference; SBP p= 0.025, DBP p=0.003, adjustments for age and follow-up time). In
women, baseline job strain was associated with higher blood pressures at baseline, but
no significant differences in blood pressure changes between groups with different work
characteristics were seen at follow-up.
In Paper III, an I/D polymorphism in the adrenergic ?2B-receptor was studied in women
and men (n=2964). Men with the DD-variant of the receptor and job strain had higher
SBP and DBP than all other gene?work characteristic combinations. The interaction
between the DD polymorphism and job strain was significant; p=0.008 for SBP, and
p=0.03 for DBP, adjusted for age, body mass index, occupational status and country of
birth. The decision latitude dimension was more influential than the demand dimension.
In Paper IV, an interaction between work characteristics and the Arg389Gly
polymorphism in the ?1-adrenergic receptor in relation to blood pressure levels was
studied, with significant findings in men.
Our findings confirm previous results of the detrimental effects of chronic stress on the
prospective CVD risk. The findings in Paper II indicate that elevation of blood pressure
in men might mediate the increased CVD risk. For the first time, significant interactions
between genetic factors and job stress, associating with elevated blood pressures, have
been described. If these findings hold true in further research, they provide a new
understanding of the mechanisms of stress, with potential implications for
pharmacogenomics. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/548880
- author
- Öhlin, Bertil LU
- supervisor
-
- Peter Nilsson LU
- Olle Melander LU
- opponent
-
- Prof. Thelle, Dag, Oslo, Norway
- organization
- publishing date
- 2007
- type
- Thesis
- publication status
- published
- subject
- keywords
- Kardiovaskulära systemet, receptor, Cardiovascular system, Medicin (människa och djur), Medicine (human and vertebrates), adrenergic, alpha-2, beta-1, mortality, morbidity, prospective, studies, polymorphism, work, stress, blood pressure, hypertension
- in
- Lund University Faculty of Medicine Doctoral Dissertation Series
- pages
- 160 pages
- publisher
- Department of Clinical Sciences, Lund University
- defense location
- Aulan, Medicinska kliniken, Entrance 35, University Hospital, Malmö
- defense date
- 2007-06-08 13:00:00
- ISSN
- 1652-8220
- ISBN
- 978-91-85559-79-4
- language
- English
- LU publication?
- yes
- additional info
- B Öhlin, PM Nilsson, JÅ Nilsson and G Berglund. 2004. Chronic psychosocial stress predicts long-term cardiovascular morbidity and mortality in middle-aged men. Eur Heart J, vol 25 pp 867-73.B Öhlin, G Berglund, M Rosvall and PM Nilsson. 2007. Job strain in men, but not in women, predicts a significant rise in blood pressure after 6.5 years of follow-up. J Hypertens, vol 25 pp 525-31.B Öhlin, G Berglund, PM Nilsson and O Melander. 2007. Job strain, decision latitude and alpha2B-adrenergic receptor polymorphism significantly interact, and associate with higher blood pressures in men. J Hypertens, (inpress)B Öhlin, G Berglund, PM Nilsson and O Melander. . Job strain, job demands and adrenergic beta1-receptor-polymorphism - a possible interaction affecting blood pressures in men. (manuscript)
- id
- 67edbd1a-a2ec-47b6-bf54-f87ec5c6501f (old id 548880)
- date added to LUP
- 2016-04-01 15:20:22
- date last changed
- 2023-04-18 19:59:06
@phdthesis{67edbd1a-a2ec-47b6-bf54-f87ec5c6501f, abstract = {{Psychosocial stress has been linked to both hypertension and cardiovascular disease<br/><br> <br/><br> (CVD), and hypertension has been proposed to be one mediator of the increased CVD<br/><br> <br/><br> risk in subjects reporting stress. Genetic susceptibility for blood pressure elevation in<br/><br> <br/><br> relation to stress has been proposed, but so far there is little evidence. We aimed to<br/><br> <br/><br> study the prospective CVD risk of chronic stress (Paper I), and the prospective effect on<br/><br> <br/><br> blood pressure levels of work-related stress (Paper II). In Papers III-IV the aim was to<br/><br> <br/><br> explore a hypothesised work stress?gene interaction in relation to blood pressure.<br/><br> <br/><br> In Paper I, 13,306 participants (2741 women) from the population-based screening and<br/><br> <br/><br> intervention programme Malmö Preventive Project were followed for a median of 21<br/><br> <br/><br> years. Men and women with self-reported chronic stress at baseline suffered an<br/><br> <br/><br> increased risk of cardiovascular events compared to those without baseline stress (RR<br/><br> <br/><br> 1.27; 95%CI 1.15-1.27). The statistical significances were stronger in men than in<br/><br> <br/><br> women.<br/><br> <br/><br> In Papers II-IV different sub-cohorts from the population-based Malmö Diet and Cancer<br/><br> <br/><br> Study (MDCS) were included. Work stress was assessed according to the Karasek<br/><br> <br/><br> demand-control model. In Paper II, men with baseline job strain (?stress?) had a<br/><br> <br/><br> significantly greater systolic blood pressure (SBP) and diastolic blood pressure (DBP)<br/><br> <br/><br> elevation at follow-up compared to men with relaxed working conditions (significance for<br/><br> <br/><br> difference; SBP p= 0.025, DBP p=0.003, adjustments for age and follow-up time). In<br/><br> <br/><br> women, baseline job strain was associated with higher blood pressures at baseline, but<br/><br> <br/><br> no significant differences in blood pressure changes between groups with different work<br/><br> <br/><br> characteristics were seen at follow-up.<br/><br> <br/><br> In Paper III, an I/D polymorphism in the adrenergic ?2B-receptor was studied in women<br/><br> <br/><br> and men (n=2964). Men with the DD-variant of the receptor and job strain had higher<br/><br> <br/><br> SBP and DBP than all other gene?work characteristic combinations. The interaction<br/><br> <br/><br> between the DD polymorphism and job strain was significant; p=0.008 for SBP, and<br/><br> <br/><br> p=0.03 for DBP, adjusted for age, body mass index, occupational status and country of<br/><br> <br/><br> birth. The decision latitude dimension was more influential than the demand dimension.<br/><br> <br/><br> In Paper IV, an interaction between work characteristics and the Arg389Gly<br/><br> <br/><br> polymorphism in the ?1-adrenergic receptor in relation to blood pressure levels was<br/><br> <br/><br> studied, with significant findings in men.<br/><br> <br/><br> Our findings confirm previous results of the detrimental effects of chronic stress on the<br/><br> <br/><br> prospective CVD risk. The findings in Paper II indicate that elevation of blood pressure<br/><br> <br/><br> in men might mediate the increased CVD risk. For the first time, significant interactions<br/><br> <br/><br> between genetic factors and job stress, associating with elevated blood pressures, have<br/><br> <br/><br> been described. If these findings hold true in further research, they provide a new<br/><br> <br/><br> understanding of the mechanisms of stress, with potential implications for<br/><br> <br/><br> pharmacogenomics.}}, author = {{Öhlin, Bertil}}, isbn = {{978-91-85559-79-4}}, issn = {{1652-8220}}, keywords = {{Kardiovaskulära systemet; receptor; Cardiovascular system; Medicin (människa och djur); Medicine (human and vertebrates); adrenergic; alpha-2; beta-1; mortality; morbidity; prospective; studies; polymorphism; work; stress; blood pressure; hypertension}}, language = {{eng}}, publisher = {{Department of Clinical Sciences, Lund University}}, school = {{Lund University}}, series = {{Lund University Faculty of Medicine Doctoral Dissertation Series}}, title = {{Psychosocial stress in relation to blood pressure and cardivascular disease - epidemiological and genetic aspects}}, year = {{2007}}, }