Psychosocial stress in relation to blood pressure and cardivascular disease - epidemiological and genetic aspects

Bertil Öhlin

Psychosocial stress in relation to blood pressure and cardivascular disease - epidemiological and genetic aspects

Bertil Öhlin

Internal Medicine - Epidemiology

Research output: Thesis › Doctoral Thesis (compilation)

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, 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.

Original language	English
Qualification	Doctor
Awarding Institution	Department of Clinical Sciences, Malmö
Supervisors/Advisors	Nilsson, Peter M, Supervisor Melander, Olle, Supervisor
Award date	2007 Jun 8
Publisher	Department of Clinical Sciences, Lund University
ISBN (Print)	978-91-85559-79-4
Publication status	Published - 2007

Bibliographical note

Defence details

Date: 2007-06-08
Time: 13:00
Place: Aulan, Medicinska kliniken, Entrance 35, University Hospital, Malmö

External reviewer(s)

Name: Thelle, Dag
Title: Prof.
Affiliation: Oslo, Norway

---

<div class="article_info">B Öhlin, PM Nilsson, JÅ Nilsson and G Berglund. <span class="article_issue_date">2004</span>. <span class="article_title">Chronic psychosocial stress predicts long-term cardiovascular morbidity and mortality in middle-aged men.</span> <span class="journal_series_title">Eur Heart J</span>, <span class="journal_volume">vol 25</span> <span class="journal_pages">pp 867-73</span>.</div>
<div class="article_info">B Öhlin, G Berglund, M Rosvall and PM Nilsson. <span class="article_issue_date">2007</span>. <span class="article_title">Job strain in men, but not in women, predicts a significant rise in blood pressure after 6.5 years of follow-up.</span> <span class="journal_series_title">J Hypertens</span>, <span class="journal_volume">vol 25</span> <span class="journal_pages">pp 525-31</span>.</div>
<div class="article_info">B Öhlin, G Berglund, PM Nilsson and O Melander. <span class="article_issue_date">2007</span>. <span class="article_title">Job strain, decision latitude and alpha2B-adrenergic receptor polymorphism significantly interact, and associate with higher blood pressures in men.</span> <span class="journal_series_title">J Hypertens</span>, (inpress)</div>
<div class="article_info">B Öhlin, G Berglund, PM Nilsson and O Melander. <span class="article_issue_date"></span>. <span class="article_title">Job strain, job demands and adrenergic beta1-receptor-polymorphism - a possible interaction affecting blood pressures in men.</span> (manuscript)</div>

Subject classification (UKÄ)

Clinical Medicine

Free 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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Cite this

@phdthesis{67edbd1aa2ec47b6bf54f87ec5c6501f,

title = "Psychosocial stress in relation to blood pressure and cardivascular disease - epidemiological and genetic aspects",

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, 13,306 participants (2741 women) from the population-based screening and intervention programme Malm{\"o} 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 Malm{\"o} 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.",

keywords = "Kardiovaskul{\"a}ra systemet, receptor, Cardiovascular system, Medicin (m{\"a}nniska och djur), Medicine (human and vertebrates), adrenergic, alpha-2, beta-1, mortality, morbidity, prospective, studies, polymorphism, work, stress, blood pressure, hypertension",

author = "Bertil {\"O}hlin",

note = "Defence details Date: 2007-06-08 Time: 13:00 Place: Aulan, Medicinska kliniken, Entrance 35, University Hospital, Malm{\"o} External reviewer(s) Name: Thelle, Dag Title: Prof. Affiliation: Oslo, Norway --- <div class={"}article_info{"}>B {\"O}hlin, PM Nilsson, J{\AA} Nilsson and G Berglund. <span class={"}article_issue_date{"}>2004</span>. <span class={"}article_title{"}>Chronic psychosocial stress predicts long-term cardiovascular morbidity and mortality in middle-aged men.</span> <span class={"}journal_series_title{"}>Eur Heart J</span>, <span class={"}journal_volume{"}>vol 25</span> <span class={"}journal_pages{"}>pp 867-73</span>.</div> <div class={"}article_info{"}>B {\"O}hlin, G Berglund, M Rosvall and PM Nilsson. <span class={"}article_issue_date{"}>2007</span>. <span class={"}article_title{"}>Job strain in men, but not in women, predicts a significant rise in blood pressure after 6.5 years of follow-up.</span> <span class={"}journal_series_title{"}>J Hypertens</span>, <span class={"}journal_volume{"}>vol 25</span> <span class={"}journal_pages{"}>pp 525-31</span>.</div> <div class={"}article_info{"}>B {\"O}hlin, G Berglund, PM Nilsson and O Melander. <span class={"}article_issue_date{"}>2007</span>. <span class={"}article_title{"}>Job strain, decision latitude and alpha2B-adrenergic receptor polymorphism significantly interact, and associate with higher blood pressures in men.</span> <span class={"}journal_series_title{"}>J Hypertens</span>, (inpress)</div> <div class={"}article_info{"}>B {\"O}hlin, G Berglund, PM Nilsson and O Melander. <span class={"}article_issue_date{"}></span>. <span class={"}article_title{"}>Job strain, job demands and adrenergic beta1-receptor-polymorphism - a possible interaction affecting blood pressures in men.</span> (manuscript)</div>",

year = "2007",

language = "English",

isbn = "978-91-85559-79-4",

series = "Lund University Faculty of Medicine Doctoral Dissertation Series ",

publisher = "Department of Clinical Sciences, Lund University",

type = "Doctoral Thesis (compilation)",

school = "Department of Clinical Sciences, Malm{\"o}",

}

TY - THES

T1 - Psychosocial stress in relation to blood pressure and cardivascular disease - epidemiological and genetic aspects

AU - Öhlin, Bertil

N1 - Defence details Date: 2007-06-08 Time: 13:00 Place: Aulan, Medicinska kliniken, Entrance 35, University Hospital, Malmö External reviewer(s) Name: Thelle, Dag Title: Prof. Affiliation: Oslo, Norway --- <div class="article_info">B Öhlin, PM Nilsson, JÅ Nilsson and G Berglund. <span class="article_issue_date">2004</span>. <span class="article_title">Chronic psychosocial stress predicts long-term cardiovascular morbidity and mortality in middle-aged men.</span> <span class="journal_series_title">Eur Heart J</span>, <span class="journal_volume">vol 25</span> <span class="journal_pages">pp 867-73</span>.</div> <div class="article_info">B Öhlin, G Berglund, M Rosvall and PM Nilsson. <span class="article_issue_date">2007</span>. <span class="article_title">Job strain in men, but not in women, predicts a significant rise in blood pressure after 6.5 years of follow-up.</span> <span class="journal_series_title">J Hypertens</span>, <span class="journal_volume">vol 25</span> <span class="journal_pages">pp 525-31</span>.</div> <div class="article_info">B Öhlin, G Berglund, PM Nilsson and O Melander. <span class="article_issue_date">2007</span>. <span class="article_title">Job strain, decision latitude and alpha2B-adrenergic receptor polymorphism significantly interact, and associate with higher blood pressures in men.</span> <span class="journal_series_title">J Hypertens</span>, (inpress)</div> <div class="article_info">B Öhlin, G Berglund, PM Nilsson and O Melander. <span class="article_issue_date"></span>. <span class="article_title">Job strain, job demands and adrenergic beta1-receptor-polymorphism - a possible interaction affecting blood pressures in men.</span> (manuscript)</div>

PY - 2007

Y1 - 2007

N2 - 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.

AB - 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.

KW - Kardiovaskulära systemet

KW - receptor

KW - Cardiovascular system

KW - Medicin (människa och djur)

KW - Medicine (human and vertebrates)

KW - adrenergic

KW - alpha-2

KW - beta-1

KW - mortality

KW - morbidity

KW - prospective

KW - studies

KW - polymorphism

KW - work

KW - stress

KW - blood pressure

KW - hypertension

M3 - Doctoral Thesis (compilation)

SN - 978-91-85559-79-4

T3 - Lund University Faculty of Medicine Doctoral Dissertation Series

PB - Department of Clinical Sciences, Lund University

ER -

Psychosocial stress in relation to blood pressure and cardivascular disease - epidemiological and genetic aspects

Abstract

Bibliographical note

Subject classification (UKÄ)

Free keywords

UN SDGs

Fingerprint

Cite this