Abstract

Chronic stress at work shows a moderate but robust longitudinal association with cardiovascular disease (CVD). Atherosclerosis is a pathophysiological process of most CVD, for which intima media thickness (IMT) of the carotid artery is used as an early marker. Its relationship with stress at work has remained largely unexplored, and the present study therefore aimed to elucidate the association between stress at work, assessed as effort-reward imbalance (ERI), and IMT. This cross-sectional study comprised of 501 male German employees aged 42 (19–64) years at enrollment into the Mannheim Industrial Cohort Study. Clinical assessments used fasting blood samples and IMT measurement. Self-report questionnaires assessed sources of perceived stress. Analyses adjusted for medical history, life style, and socio-economic status (SES) indicators as well as general perceived stress and worries to determine the specificity of ERI. Linear regression models estimated the association of ERI with IMT, stratifying for age groups and adjusting for potential confounders. ERI ratio increased until the age of 50 years and abated thereafter. In participants younger than 50 years IMT measurements were not associated with ERI ratios. However, despite lower mean ERI ratios in participants older than 50 years, this age group showed a significant relationship with IMT (standardized Beta = .36, p < .01), adjusting for multiple confounders including general perceived stress and worries. These analyses suggest that atherosclerosis in older employees is specifically related to stress at work. Longitudinal studies will help to elucidate the temporal relationship between stress exposure and downstream biological mechanisms.

• Lay summary

• Our study explored the association of job stress and the calcification of the carotid artery in German employees. We found out that this association is stronger in employees older than 50 years. In addition, it is independent of medical risk factors and stress caused by private issues.

摘要

工作中的慢性压力显示出与心血管疾病 (CVD) 的适度但强烈的纵向关联。动脉粥样硬化是大多数 CVD 的病理生理过程，颈动脉的内膜中层厚度 (IMT) 被用作早期标志物。它与工作压力的关系在很大程度上仍未得到探索，因此本研究旨在阐明工作压力（评估为努力回报失衡 (ERI)）与 IMT 之间的关联。这项横断面研究由 501 名年龄在 42 (19-64) 岁的德国男性雇员组成，参与曼海姆工业队列研究。临床评估使用空腹血样和 IMT 测量。自我报告问卷评估了感知压力的来源。根据病史、生活方式、和社会经济地位 (SES) 指标以及一般感知压力和担忧，以确定 ERI 的特异性。线性回归模型估计 ERI 与 IMT 的关联，对年龄组进行分层并调整潜在的混杂因素。ERI 比率一直增加到 50 岁，此后逐渐减弱。在年龄小于 50 岁的参与者中，IMT 测量值与 ERI 比率无关。然而，尽管 50 岁以上参与者的平均 ERI 比率较低，但该年龄组显示出与 IMT 的显着关系（标准化 Beta = .36，ERI 比率一直增加到 50 岁，此后逐渐减弱。在年龄小于 50 岁的参与者中，IMT 测量值与 ERI 比率无关。然而，尽管 50 岁以上参与者的平均 ERI 比率较低，但该年龄组显示出与 IMT 的显着关系（标准化 Beta = .36，ERI 比率一直增加到 50 岁，此后逐渐减弱。在年龄小于 50 岁的参与者中，IMT 测量值与 ERI 比率无关。然而，尽管 50 岁以上参与者的平均 ERI 比率较低，但该年龄组显示出与 IMT 的显着关系（标准化 Beta = .36，p  < .01)，针对多种混杂因素进行调整，包括普遍感知的压力和担忧。这些分析表明，老年员工的动脉粥样硬化与工作压力特别相关。纵向研究将有助于阐明压力暴露与下游生物机制之间的时间关系。

• 奠定总结

• 我们的研究探讨了德国员工的工作压力与颈动脉钙化之间的关系。我们发现这种关联在 50 岁以上的员工中更强。此外，它与医疗风险因素和私人问题引起的压力无关。